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General Discussion => The New Joe Montgomery Birther Pit => Topic started by: ednksu on March 13, 2017, 06:28:59 PM
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https://www.cbo.gov/sites/default/files/115th-congress-2017-2018/costestimate/americanhealthcareact_0.pdf
Those provisions, taken together, would reduce projected deficits by $935 billion over the 2017-2026 period. Other provisions would increase deficits by $599 billion, mostly by reducing tax revenues. All told, deficits would be reduced by $337 billion over that period, CBO and JCT estimate.
That reduction would stem primarily from lower enrollment throughout the period, culminating in 14 million fewer Medicaid enrollees by 2026, a reduction of about 17 percent relative to the number under current law.
According to CBO’s estimates, that effect would be modest in the near term, but by 2026, on an average annual basis, 5 million fewer people would be enrolled in Medicaid than would have been enrolled under current law.
Roughly 2 million fewer people, on net, would enroll in employment-based coverage in 2020, and that number would grow to roughly 7 million in 2026. Part of that net reduction in employment-based coverage would occur because fewer employees would take up the offer of such coverage in the absence of the individual mandate penalties.
The legislation would tend to increase average premiums in the nongroup market prior to 2020 and lower average premiums thereafter, relative to the outcomes under current law.
Later, following additional changes to subsidies for insurance purchased in the nongroup market and to the Medicaid program, the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026.
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Sounds good.
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The best part was when people in congress screamed fake news at it
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64 year old making $26,500 currently paying $1,600, would pay $14,600 under AHCA
64 year old making $68,200 currently paying $15,300, would pay $14,600 under AHCA
:confused:
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when all the poor people die because they can't afford healthcare, who will work in all of the rich peoples factories?
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Robots
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robots and immigrants
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64 year old making $26,500 currently paying $1,600, would pay $14,600 under AHCA
64 year old making $68,200 currently paying $15,300, would pay $14,600 under AHCA
:confused:
$14,600 in out of pocket expenses for Person A works out to 143 days out of their work year (55%!!) just to afford their healthcare. Have fun eating all that cat food, Person A! Best you can hope for is that it's not Trump brand cat food.
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It's worth noting that the CBO completely botched its scoring and predictions regarding Obamacare. Politically, this isn't helpful to the GOP (or could it save them from a serious blunder?), but substantively it is almost meaningless.
CBO scoring aside, there is much to dislike about this bill, mainly because it doesn't touch anything the GOP isn't confident they can press through with budget reconciliation (50 votes) - which is basically a whole lot of Obamacare's most shitty shittiness.
The GOP says not to worry, those reforms will be in the "Phase 2 and 3" but if the Dems are going to filibuster those phases anyway, wouldn't the politically smart move be to do comprehensive reform while Dems still own the imploding Obamacare shitstorm? Once the GOP rams through phase 1, they own it, and phase 1 doesn't fix much of anything and may make things worse without the other reforms.
Which is why it might actually be a good thing if the CBO encourages the GOP to hit the abort button and go to a more comprehensive approach.
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The GOP could just be incompetent, but a cynic might conclude that the insurance lobbyists crafted this bill to avoid market competition and preserve taxpayer subsidies. Just like they got with Obamacare. Cynical, I know....
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64 year old making $26,500 currently paying $1,600, would pay $14,600 under AHCA
64 year old making $68,200 currently paying $15,300, would pay $14,600 under AHCA
:confused:
1 yr from medicare, dummy
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If they go through with this, they're crazy imo
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Neither Obamacare or this plan fixes healthcare. Too many lobbyists to actually fix it vs what these plans do and just shift around who pays for a bad system
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Medicare for all.
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It's worth noting that the CBO completely botched its scoring and predictions regarding Obamacare. Politically, this isn't helpful to the GOP (or could it save them from a serious blunder?), but substantively it is almost meaningless.
CBO scoring aside, there is much to dislike about this bill, mainly because it doesn't touch anything the GOP isn't confident they can press through with budget reconciliation (50 votes) - which is basically a whole lot of Obamacare's most shitty shittiness.
The GOP says not to worry, those reforms will be in the "Phase 2 and 3" but if the Dems are going to filibuster those phases anyway, wouldn't the politically smart move be to do comprehensive reform while Dems still own the imploding Obamacare shitstorm? Once the GOP rams through phase 1, they own it, and phase 1 doesn't fix much of anything and may make things worse without the other reforms.
Which is why it might actually be a good thing if the CBO encourages the GOP to hit the abort button and go to a more comprehensive approach.
Yeah. I don't even think most of the republicans like it, but enough of them are terrified of Trump that it just might pass.
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It's worth noting that the CBO completely botched its scoring and predictions regarding Obamacare. Politically, this isn't helpful to the GOP (or could it save them from a serious blunder?), but substantively it is almost meaningless.
CBO scoring aside, there is much to dislike about this bill, mainly because it doesn't touch anything the GOP isn't confident they can press through with budget reconciliation (50 votes) - which is basically a whole lot of Obamacare's most shitty shittiness.
The GOP says not to worry, those reforms will be in the "Phase 2 and 3" but if the Dems are going to filibuster those phases anyway, wouldn't the politically smart move be to do comprehensive reform while Dems still own the imploding Obamacare shitstorm? Once the GOP rams through phase 1, they own it, and phase 1 doesn't fix much of anything and may make things worse without the other reforms.
Which is why it might actually be a good thing if the CBO encourages the GOP to hit the abort button and go to a more comprehensive approach.
Yeah. I don't even think most of the republicans like it, but enough of them are terrified of Trump that it just might pass.
They should be terrified. Look how he neutered Ryan and Cruz. I used to hear Ted Cruz's opinion on every little thing and now it's like he's not even in the Senate anymore.
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It's worth noting that the CBO completely botched its scoring and predictions regarding Obamacare. Politically, this isn't helpful to the GOP (or could it save them from a serious blunder?), but substantively it is almost meaningless.
CBO scoring aside, there is much to dislike about this bill, mainly because it doesn't touch anything the GOP isn't confident they can press through with budget reconciliation (50 votes) - which is basically a whole lot of Obamacare's most shitty shittiness.
The GOP says not to worry, those reforms will be in the "Phase 2 and 3" but if the Dems are going to filibuster those phases anyway, wouldn't the politically smart move be to do comprehensive reform while Dems still own the imploding Obamacare shitstorm? Once the GOP rams through phase 1, they own it, and phase 1 doesn't fix much of anything and may make things worse without the other reforms.
Which is why it might actually be a good thing if the CBO encourages the GOP to hit the abort button and go to a more comprehensive approach.
Yeah. I don't even think most of the republicans like it, but enough of them are terrified of Drumpf that it just might pass.
They should be terrified. Look how he neutered Ryan and Cruz. I used to hear Ted Cruz's opinion on every little thing and now it's like he's not even in the Senate anymore.
If they had any balls they would, but they don't want to miss the chance of maybe reigning him in. All of it is a mess, oh well.
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Wouldn't that 64 year old be sitting on a crap ton of retirement money?
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Wouldn't that 64 year old be sitting on a crap ton of retirement money?
Probably not. Most people are idiots.
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Wouldn't that 64 year old be sitting on a crap ton of retirement money?
Probably not. Most people are idiots.
Well, then in your idiot scenario wouldn't the person still be working? And wouldn't they be making a lot more than $24k or whatever it was?
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emo, shut up
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21 year old making 26k pays 1700 now would pay 1450!
40 year old making 26k pays 1700 now would pay 2400
21 year old making 68k pays 5100 now would pay 1450
40 year old making 68k pays 6500 now would pay 2400
Perfectly sane.
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Hot damn young wealthy people are about to get paid son!
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It's worth noting that the CBO completely botched its scoring and predictions regarding Obamacare. Politically, this isn't helpful to the GOP (or could it save them from a serious blunder?), but substantively it is almost meaningless.
CBO scoring aside, there is much to dislike about this bill, mainly because it doesn't touch anything the GOP isn't confident they can press through with budget reconciliation (50 votes) - which is basically a whole lot of Obamacare's most shitty shittiness.
The GOP says not to worry, those reforms will be in the "Phase 2 and 3" but if the Dems are going to filibuster those phases anyway, wouldn't the politically smart move be to do comprehensive reform while Dems still own the imploding Obamacare shitstorm? Once the GOP rams through phase 1, they own it, and phase 1 doesn't fix much of anything and may make things worse without the other reforms.
Which is why it might actually be a good thing if the CBO encourages the GOP to hit the abort button and go to a more comprehensive approach.
You realize that the CBO estimates were off because nearly half the states in this country decided to eff their own citizens right?
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Hot damn young wealthy people are about to get paid son!
this thing would be great for me. perfectly timed too.
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Why wouldn't older sick people have to pay more for health insurance than younget not sick people?
Why the eff are we paying for anyone's health insurance at all?
Why has health insurance and healthcare been conflated?
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I'm a believer that you should get the same rate for life. The younger you join, the lower your rate. I don't like rates going up just because you get old.
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Why wouldn't older sick people have to pay more for health insurance than younget not sick people?
Why the eff are we paying for anyone's health insurance at all?
Why has health insurance and healthcare been conflated?
Agreed on last point.
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I'm a believer that you should get the same rate for life. The younger you join, the lower your rate. I don't like rates going up just because you get old.
You pay more based on your risk in virtually every other insurance market right?
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But you don't have to own a car....
Need to be working on better healthcare, not within the constructs of insurance companies.
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I'm a believer that you should get the same rate for life. The younger you join, the lower your rate. I don't like rates going up just because you get old.
You pay more based on your risk in virtually every other insurance market right?
Not necessarily for life insurance.
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I'm a believer that you should get the same rate for life. The younger you join, the lower your rate. I don't like rates going up just because you get old.
You pay more based on your risk in virtually every other insurance market right?
Not necessarily for life insurance.
Oh?
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I'm a believer that you should get the same rate for life. The younger you join, the lower your rate. I don't like rates going up just because you get old.
You pay more based on your risk in virtually every other insurance market right?
Not necessarily for life insurance.
Oh?
Yeah, you can get whole life with a fixed premium. It just costs more.
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But you don't have to own a car....
Need to be working on better healthcare, not within the constructs of insurance companies.
Healthcare is fantastic in this country
.... As long as you can afford it
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i get tired of people blaming insurance companies. they're just pass throughs, the problem is the doctors.
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i get tired of people blaming insurance companies. they're just pass throughs, the problem is the doctors.
Agreed if "doctors" meaning hospitals, pharma, etc. as well.
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Do insurers have a strong audit presence in hospitals? The amount of waste that I've anecdotally become aware of makes me think there isn't.
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Well if you've heard anectdotes that's that then.
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I think you just about have to start with reforming the FDA to lower healthcare costs. Congressmen also need to stop getting advice from the AMA but I don't see any good way to accomplish that.
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i get tired of people blaming insurance companies. they're just pass throughs, the problem is the doctors.
???
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Do insurers have a strong audit presence in hospitals? The amount of waste that I've anecdotally become aware of makes me think there isn't.
Kinda, and they are there for pharmacies too, in a big way.
I'm curious what you see as waste?
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Do insurers have a strong audit presence in hospitals? The amount of waste that I've anecdotally become aware of makes me think there isn't.
Kinda, and they are there for pharmacies too, in a big way.
I'm curious what you see as waste?
There are a lot of unnecessary tests run.
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i get tired of people blaming insurance companies. they're just pass throughs, the problem is the doctors.
Not sure if you're joking, but this is amazingly wrong. Insurance companies are becoming very vertically integrated in the healthcare industry with processing and bureaucracy. They are driving up costs and forcing providers and customers into their networks.
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Sys is right dude, we gots a problem on the supply side bros
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What's the average w-2 income for a non-family practitioner m.d., like $600k per year? Every hospital has like 40 "administrators" making $175k+. eff, an rna working 3 days per week doing mom chores makes like $80k. In every city the hospital is the largest employer. It's not hard to figure out why it's expensive. The insurance company is the only one keeping it from being 3x as expensive
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This thread is about blaming politicians.
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What's the average w-2 income for a non-family practitioner m.d., like $600k per year? Every hospital has like 40 "administrators" making $175k+. eff, an rna working 3 days per week doing mom chores makes like $80k. In every city the hospital is the largest employer. It's not hard to figure out why it's expensive. The insurance company is the only one keeping it from being 3x as expensive
Closer to 65k for a nurse with 20+ years experience in KS. In CA it can rise up to 80k for an RN.
I'm fairly sure family docs start at around 125k in KS. I do know a crna that made 30k I'm one night though.
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It is Ryancare. The Beloved could never come up with something like this.
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i get tired of people blaming insurance companies. they're just pass throughs, the problem is the doctors.
Not sure if you're joking, but this is amazingly wrong. Insurance companies are becoming very vertically integrated in the healthcare industry with processing and bureaucracy. They are driving up costs and forcing providers and customers into their networks.
No, sys is right.
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3rd party payers inflate prices, they enable the first party to charge more for their product or service than they could to cash or private finance buyers. Consider what college tuition would cost without federally backed student loans, would real estate values have bubbled without poor underwriting practices? Low deductible health plans also inflate the cost of healthcare. People need skin in the game if you want to control the cost of anything.
Its even worse than that - we're subsidizing and/or masking (through employer co-funding) the cost to the "demand" side while letting the providers on the "supply" side run wild absorbing all that funding. Medicare reimbursement rates are a partial check on that supply side, but generally inadequate overall. Providers are still free to accept network contract/discount rates or not. Consider the hospital/provider in/out of network shell game that is popular at the moment - Purely providers gaming the setup: divide and conquer.
Pharma has no checks on what they can command. And regarding pharma - pretty sure we're (the U.S.) holding the bag for capped prices in all the other price controlled nationalized medicine countries.
Quote from: ednksu on March 14, 2017, 11:04:58 PM
Quote from: sys on March 14, 2017, 10:00:16 PM
i get tired of people blaming insurance companies. they're just pass throughs, the problem is the doctors.
Not sure if you're joking, but this is amazingly wrong. Insurance companies are becoming very vertically integrated in the healthcare industry with processing and bureaucracy. They are driving up costs and forcing providers and customers into their networks.
While they are becoming the gatekeeper, they're still just a middleman - albeit a very fat one - skimming their 20-30-40%.
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i get tired of people blaming insurance companies. they're just pass throughs, the problem is the doctors.
Not sure if you're joking, but this is amazingly wrong. Insurance companies are becoming very vertically integrated in the healthcare industry with processing and bureaucracy. They are driving up costs and forcing providers and customers into their networks.
No, sys is right.
Think that all you want, but it doesn't make it right. Who is setting reimbursement rates? Who is setting service rates? Who is setting processing rates? Who is making lopsided contracts? Who is making in network groups and out of network groups?
This is the problem when people think that just because you make a lot of money means you must be damaging the industry. What is a bigger issue, a doctor making enough to own a nice car or CVS buying Caremark and creating a vertically integrated structure where you can now go to a doctor, get your script filled, have all that processed to your insurance, at a company that is now related to insurance companies? Better yet, they're doing all their paperwork on McKesson infrastructure (everything from POS terminals at the doctors office to billing suites) using pharmaceuticals provided by McKesson (who decides which generics they like at what price).
So anyone who thinks insurance companies are a "pass through" for doctors is leaving out most of the cost associated with medicine.
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i get tired of people blaming insurance companies. they're just pass throughs, the problem is the doctors.
Not sure if you're joking, but this is amazingly wrong. Insurance companies are becoming very vertically integrated in the healthcare industry with processing and bureaucracy. They are driving up costs and forcing providers and customers into their networks.
No, sys is right.
Think that all you want, but it doesn't make it right. Who is setting reimbursement rates? Who is setting service rates? Who is setting processing rates? Who is making lopsided contracts? Who is making in network groups and out of network groups?
This is the problem when people think that just because you make a lot of money means you must be damaging the industry. What is a bigger issue, a doctor making enough to own a nice car or CVS buying Caremark and creating a vertically integrated structure where you can now go to a doctor, get your script filled, have all that processed to your insurance, at a company that is now related to insurance companies? Better yet, they're doing all their paperwork on McKesson infrastructure (everything from POS terminals at the doctors office to billing suites) using pharmaceuticals provided by McKesson (who decides which generics they like at what price).
So anyone who thinks insurance companies are a "pass through" for doctors is leaving out most of the cost associated with medicine.
That vertical integration lowers costs, edn. "Doctors" is a very broad term, but at the end of the day, health care costs a lot because people charge a lot for it. The AMA (an association of doctors) actively works to restrict the number of doctors available to the public, which also helps to keep costs inflated.
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not sure what your experience is in the field, but there are a lot of fallacies you're conflating to make your point. The AMA isn't really restricting to make sure there are fewer providers. There is an epidemic of shortages in many areas. There is a supply problem because of many other issues, one of the biggest problems is pay in rural areas and support and infrastructure in those areas. What is one of the biggest issues in many of those place, and something the advocated for, expanding medicaid so they can get money to subsidies the poor people already using services. That leads to the other issue that the ACA tried to fix, the payment of medical care. Right now the costs are already socialized. That is why we $20 aspirin.
Simply looking at a doctor's pay check (which isn't broad at all, are you sure you don't mean "provider?") is a dumb way to look at the high price of medicine in this country.
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Do insurers have a strong audit presence in hospitals? The amount of waste that I've anecdotally become aware of makes me think there isn't.
Kinda, and they are there for pharmacies too, in a big way.
I'm curious what you see as waste?
Unnecessary CYA tests for sure.
You may recall an example I gave where an admitted patient was fed food high in sugar, then had blood tested and found high glucose, and then treated with insulin. Stupid from several angles and potentially fraud IMO.
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The hospital was to bill an extra $1200/day to the insurer for this.
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not sure what your experience is in the field, but there are a lot of fallacies you're conflating to make your point. The AMA isn't really restricting to make sure there are fewer providers. There is an epidemic of shortages in many areas. There is a supply problem because of many other issues, one of the biggest problems is pay in rural areas and support and infrastructure in those areas. What is one of the biggest issues in many of those place, and something the advocated for, expanding medicaid so they can get money to subsidies the poor people already using services. That leads to the other issue that the ACA tried to fix, the payment of medical care. Right now the costs are already socialized. That is why we $20 aspirin.
Simply looking at a doctor's pay check (which isn't broad at all, are you sure you don't mean "provider?") is a dumb way to look at the high price of medicine in this country.
We need more doctors. More supply will lower the amount an individual doctor can charge and also have an effect of pushing more doctors to rural areas where there is less competition.
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I'll keep saying it - If we're gonna keep shoveling more money into the demand side - more than any other place on earth - without making offsetting adjustments on the supply side - this thing will just keep getting more out of control. About the only other option is force reductions in the actual demand.
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not sure what your experience is in the field, but there are a lot of fallacies you're conflating to make your point. The AMA isn't really restricting to make sure there are fewer providers. There is an epidemic of shortages in many areas. There is a supply problem because of many other issues, one of the biggest problems is pay in rural areas and support and infrastructure in those areas. What is one of the biggest issues in many of those place, and something the advocated for, expanding medicaid so they can get money to subsidies the poor people already using services. That leads to the other issue that the ACA tried to fix, the payment of medical care. Right now the costs are already socialized. That is why we $20 aspirin.
Simply looking at a doctor's pay check (which isn't broad at all, are you sure you don't mean "provider?") is a dumb way to look at the high price of medicine in this country.
We need more doctors. More supply will lower the amount an individual doctor can charge and also have an effect of pushing more doctors to rural areas where there is less competition.
I don't understand why people deny the AMA isn't purposefully limiting the supply. If I were them I would do it too if I could get away with it. I know EDN won't engage in that discussion earnestly but hopefully someone ITT will argue as to why it's a good thing so we can at least have a debate.
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We need to be ramping the crap up to get out more NP's and PA's. BSRN's also could have an expanded role. The supply of medical professionals (MD's, DDS's, etc) is definitely constrained, partially in the name of prestige and the money involved. It also does rightfully take an investment of time for education and training, but there are even perhaps different ways to do that and be more effective cost wise and time wise.
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CRNAs are already squeezing out Anesthesiologists
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And PAs still must has a Dr sign off. NP are autonomous.
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Which is where we need to rethink/think outside the box. With modern communications, better EMR's do we need 8+year post secondary MD's as our baseline medical provider? Morph PA's into a GP with 3 years school/1-2 years residency? There's gotta be something happen/give on the supply side or we'll never come close to cracking this thing.
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I'd really like to see the tech for self diagnostic or quantitative self take off. Would allow for fewer qualified medical professionals to service more people at a lower cost.
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PA is more than 3 years. 6 I believe.
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There are already a bunch of shitty for profit med schools churning out terrible doctors. I don't think we need anymore.
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PA is 2 years on top of the bachelors.
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Have you guys been to a hospital lately? They assign you like 10 full time servants, 3 doctors, and 5 bitchy paperwork people. Tylenol comes in individual packages instead of a 500 pill bottle, and they throw away stainless steel tools after a single use as if they were a plastic spoon from a box. It's the worst place in the world.
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So trumpcare dying in the house? Shocking.
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PA is 2 years on top of the bachelors.
So 6 years?
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Have you guys been to a hospital lately? They assign you like 10 full time servants, 3 doctors, and 5 bitchy paperwork people. Tylenol comes in individual packages instead of a 500 pill bottle, and they throw away stainless steel tools after a single use as if they were a plastic spoon from a box. It's the worst place in the world.
They do not thrown stainless steel away. There is a sterile processing department with am elevator direct from the or.
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Have you guys been to a hospital lately? They assign you like 10 full time servants, 3 doctors, and 5 bitchy paperwork people. Tylenol comes in individual packages instead of a 500 pill bottle, and they throw away stainless steel tools after a single use as if they were a plastic spoon from a box. It's the worst place in the world.
They do not thrown stainless steel away. There is a sterile processing department with am elevator direct from the or.
That's true for surgucal tools, but things like scissors are absolutely trashed. And I don't need a $60k part time nurse to administer myself tylenol or get a drink of water. A candy-striper can handle that.
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Well I hope they were putting them in sharps containers. I also have no idea where you get your wage estimates from. As i said previously, a full time nurse with 20 years experience is making 65k. Also you're not their only patient. Depending on the unit, a nurse can have 6 to 12 patients. The ICU being the main difference.
What are you in the hospital for that Tylenol and water are you're only needs?
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Last I heard starting wage for an RN was $22 dollars an hour.
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Have you guys been to a hospital lately? They assign you like 10 full time servants, 3 doctors, and 5 bitchy paperwork people. Tylenol comes in individual packages instead of a 500 pill bottle, and they throw away stainless steel tools after a single use as if they were a plastic spoon from a box. It's the worst place in the world.
They do not thrown stainless steel away. There is a sterile processing department with am elevator direct from the or.
That's true for surgucal tools, but things like scissors are absolutely trashed. And I don't need a $60k part time nurse to administer myself tylenol or get a drink of water. A candy-striper can handle that.
Infection Control. The scissors - not the nurse or the candy striper.....
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Have you guys been to a hospital lately? They assign you like 10 full time servants, 3 doctors, and 5 bitchy paperwork people. Tylenol comes in individual packages instead of a 500 pill bottle, and they throw away stainless steel tools after a single use as if they were a plastic spoon from a box. It's the worst place in the world.
They do not thrown stainless steel away. There is a sterile processing department with am elevator direct from the or.
That's true for surgucal tools, but things like scissors are absolutely trashed. And I don't need a $60k part time nurse to administer myself tylenol or get a drink of water. A candy-striper can handle that.
It's sad you're so ignorant you think that is all they do.
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http://www.cbsnews.com/news/trump-calls-house-version-of-health-care-bill-mean/
Boy I am confused. Trump and House members had a self adulation orgasmic party in the Whitehouse yard. Trump acted like he was the happiest guy in the world. Now this. We are eating each other up from the asswholee inside out.
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Last I heard starting wage for an RN was $22 dollars an hour.
way too high
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Last I heard starting wage for an RN was $22 dollars an hour.
way too high
that is prolly pretty close for a BSN (RN from a 4 year degree program) and not as close for one from a 2 year program
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(https://uploads.tapatalk-cdn.com/20170615/76df4f006a3597040213e39f8d914851.png)
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Last I heard starting wage for an RN was $22 dollars an hour.
way too high
Stay away from looking at what a travelling nurse makes then.
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Was kidding, $25/hr is not good
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https://twitter.com/JeffLieber/status/877976665065889792
Arrested Capitol Hill Protesters
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Apparently that picture still needed a caption
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https://twitter.com/MatthewACherry/status/877950347804684288
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IPhone camera?
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bunch of Libowskis iyam
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rough ridin' goldbricker
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Android for sure