American Health Reform

[Gabes-Apg]

Please note - it is not my intent to start a political arguement

i am interested in feedback/reaction to the american health reform.
we get snippets of media in australia regarding this

will the proposed changes
a) increase the opportunities for individuals (that dont have full insurance) to have have colonscopies and get diagnosed quicker. (was this a blocking point prior)

b) post diagnosis for those with chronic symptoms will meds like endocort be more readily avialable? ie subsidised

[tex]

Gabes,

I don't believe that anyone here has the foggiest idea how any of that will work, (I doubt that any of the legislators have the foggiest idea, either, for that matter). It will probably take years for most of the details to be worked out, and there will be a lot of confusion, in the meantime.

I'm guessing that three things will happen, for sure, (based on typical results of previous legislation on similar topics):

1. The outcome won't be what most people expect.

2. The cost will be much higher than anticipated.

3. The paperwork requirements be much greater, for everyone concerned.

Everything else will be up in the air for a while. I think those are pretty safe predictions, since anything that the government has a hand in, generally turns out that way.

Tex

[Gabes-Apg]

he he he i like your summary!

i did peruse some usa online newspaper articles
the things i did see that may be of benefit

- pre existing conditions for adults from 2014 will be covered.
- the medicare drug coverage and limits are changing ? better
- and strangely (why this is part of the health reform) the nutrient content disclosure on menus and takeaway foods etc!

This may be like many of our discussions regarding research and treatements... current sufferers may not see the benefit, those in the future may do......

part of the reason it is getting coverage over here is that Barrack O had to postpone his trip to Australia citing the need to stay in the USA to finalise the health reform.

[Gayle]

Interesting to hear what is being said about all this Internationally.

Nobody knows, …..

Exactly what is in the bill.

Exactly how it is going to be paid for.

If parts of it will, or will not, pass Constitutional muster in the Courts.

How much individual States will end up having to anti up -- and for what. (called unfunded mandates)

Or even ---- what exactly constitutes “Basic Health Care”. This has never been defined - anywhere.

And on and on.

This much is for sure, Tax Attorneys and Investment types are hard at work figuring out how and where money can be invested or sheltered to avoid the cost of this anticipated change. Big business may see a changed tax assessment, but in the end the consumer always pays.

Yes, Pres. Obama did cancel a scheduled trip to Australia and the Philippines. There has been a lot of “commentary” about that action in the media here too. To some it seemed to send a signal that, that part of the world may not be very important to him (Pres. O). ….. Possibly that part of the world would rather he stay home?

Nobody knows…...

Keep us posted.


Gayle

[Gabes-Apg]

he he he..... us aussies love it when the american media get the name of our prime minister incorrect....

Australian leaders go over to the states, go to the white house and photos are taken with the president like they are best mates. then you see a photo where they get the surname of our prime minister wrong it is soooo funny.

and further to the basic health care statement and it not being defined. I always have a laugh when you are on the phone organising insurance (ie car insurance or household insurance) and there is a disclaimer at the end that the call person says " ...blah blah and you have provided honest information as expected by a normal person blah blah "
one day i said "please define what a normal person is" the call person said pardon i replied what is your definition of a normal person?
they laughed. they said they have been saying that statement at least 8 - 10 times a day for the past 2 years and i was the only person that had ever asked that question.
i asked again and they replied we dont have a definition!

[MaggieRedwings]

I 100% agree with Tex on his assumptions. I am none too happy about the bill and will take that with me to the voting booth in November. This country is about to go to Hades in a handbasket - as my mother would have said.

Maggie

[starfire]

Personally, Maggie, I think it's at least halfway there.

Love, Shirley

[Polly]

Hi Gabes!

Good question! I agree that it will take a while until the public understands the complex health care reform bill. Many features won't go into effect for some years. But as a pediatrician who has spent a lifetime serving low income and disadvantaged populations, I am happy for my patients. As of this year, children can no longer be excluded for pre-existing conditions (it's 2014 for adults). And they can no longer be denied insurance once they develop problems. Also, there can be no lifetime cap on medical expenses. Parents will now be able to keep their kids on their own policies up to age 26 yrs. You can imagine what a relief this will be for the many families who have a disabled child! It is common for such families to face financial ruin (bankruptcy, foreclosure) because of exhorbitant health care expenses.

You asked about prevention. Another provision gets rid of co-pays for any preventive services in Medicare (our health program for seniors). Also drugs. Seniors will be able to get more assistance in paying for drugs.

I kow we bash docs here a lot, but do you know what percent of the health care dollar the docs get? I believe it's around 8%. And most of that goes to the specialists who perform fancy procedures. The docs who truly want to see patients over the long term, like the internists, family docs, pediatricians, and GPs get almost nothing. They are not living fancy lives like the specialists. Sigh.

Love,

Polly

[starfire]

do you know what percent of the health care dollar the docs get? I believe it's around 8%. And most of that goes to the specialists who perform fancy procedures. The docs who truly want to see patients over the long term, like the internists, family docs, pediatricians, and GPs get almost nothing. They are not living fancy lives like the specialists. Polly

Anyone who looks at their Medicare statements can see that. I don't understand why they are constantly talking about cutting those payments. They will just drive more doctors out of their practice. My OB here will probably close her practice next year. I'm sure most of her patients are Medicare. They certainly outnumber younger people around here.

Love, Shirley

[Gabes-Apg]

Polly
thanks for the interpretation and insight, when i read some notes about it the pre-existing conditions was the thing that i saw as the positive (as long as it stays that way)

it is the same here in australia, the 'everyday doctors' do not get much of the medicare fee. If you want a good doctor you have to pay 'above' the scheduled fee (for my doctor i pay $25 above the scheduled fee)
based on this - the doctors do not have the time or the incentive to do loads of research on new treatments for things like autoimmune diseases.
it is almost impossible for them to spend time on research and expand their knowledge

i have found most general doctors are receptive to patients who have done their own research and make it easier for them to solve the issue

specialists are the ones that are a bit protective and think that patients should them (evil people) and they are ones that dont support diet as a management technique.

[starfire]

If you want a good doctor you have to pay 'above' the scheduled fee (for my doctor i pay $25 above the scheduled fee).

I'm not at all sure we'll have that option.

Love, Shirley

[annie oakley]

I;m With Tex and the reat I shall keep to myself.

[Polly]

Gabes,

We have the same situation here - the gen'l docs are more flexible and more likely to work as a partner with the patient to develop a care plan. Not so the specialists. That's why we often recommend that MCers try to get their gen'l docs to prescribe/monitor the meds for MC.

Here is the U.S. the new thing is "designer" or "boutique" docs. They charge you several thousand dollars out of pocket a year and promise to be available whenever you need them. Some of my friends lost their longtime docs when they didn't want to pay the extra charges.

Love,

Polly

[barbaranoela]

My comment would condemn me to HELL~~~~~

Barbara

[ant]

Let me make an observation.

I few years back I managed a major stakeholder survey that was presented to the Government on the subject of a Children's Hospital and Pediatric Center of Excellence in Hong Kong. It gathering opinions of..... Specialists Doctors, GPs, Nurses, the Insurance Industry, Academics, Patient Support Groups, Patients and their Parents, Government Agencies and the General Public. As a result of my involvement in this I learned how extremely complicated and political the healthcare "industry" is. I also learned that many very intelligent people who make a lot of money out of the status quo use their intelligence and superior academic and social position to keep things as they are, even when there should be change.

A Children's Hospital has finally become government policy in Hong Kong. When it will be actually built is another matter.

Best, ant