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Author Topic: Medicare RX  (Read 3810 times)

spirochete

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Medicare RX
« on: November 26, 2003, 11:14:04 pm »

     Just for the record, tonight is the first time I have ever logged into this website.  I was steered this direction by my father, who ran for gov. in North Carolina on the libertarian ticket the same year Anderson got his 1% (I think, i was rather young then...)  
     I wanted to throw out my opinion that, no matter how much I am opposed in general to government programs, I really like the prescription program that is being introduced now.  Not perfect but an excellent start.  I am a physician (educated in the south, working in Mass., good possibility of living in New Hamp. soon) and have been for 8 years.  I have always said I'd take a 10% pay cut if all my medicare patients could afford the drugs  I prescribe them.  When I moved to Mass from Arkansas, that seemed to have happened (four years ago) as WAY more patients had some type of coverage compared to my home state.  This seems to have changed in the past two years alone.  Can't wait to see where this all goes....
     One other thought, anyone care to bounce around ideas regarding getting those truly disabled back into the work force via nonconventional methods? (internet, part time work, etc) We can do that via private email instead of this forum if ya prefer.
Sean
« Last Edit: November 26, 2003, 11:16:00 pm by spirochete »
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spirochete

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Re:Medicare RX
« Reply #1 on: November 26, 2003, 11:29:55 pm »

Oops, sorry, it was Clark that got the 1%.  My bad (I WAS young!)
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Kyle

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Re:Medicare RX
« Reply #2 on: November 26, 2003, 11:39:54 pm »

Pretty much everyone who posts here advocates drastically decreasing the size of the federal government.  As such, few of us like a Medicare prescription drug law that spends, on the low end, 400 billion dollars.  Your patients might be able to afford their prescriptions if the government would stop the excessive regulation and taxation of the medical and pharmaceutical industry.  There was a time when doctors and medicine were affordable.  Hell, the doctors even came to your house.  The government saw an industry that was running a little too efficiently and decided to "fix" it.  Costs soared.  Regulation and taxation were not  enough, so they implemented Medicare and imposed price caps on how much could be charged for Medicare recipients' healthcare.  This caused doctors to charge their other patients more, resulting in increased costs to those not on Medicare.  Government destroyed affordable medical care and now we will turn to a 400 billion dollar government program to fix it?  No, I don't think so.  If you were poisoned by someone, would you look to him for the antidote?  There is an antidote, but it doesn't reside in a government bill.  The antidote's label says "pure capitalism".  The directions on the bottle say "Laissez faire".
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spirochete

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Re:Medicare RX
« Reply #3 on: November 27, 2003, 07:53:16 am »

Good point, being able to afford it if those regs were gone.  Anyway to get numbers on that?

By the way, I do house calls
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Victor VI

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Re:Medicare RX
« Reply #4 on: November 27, 2003, 05:10:57 pm »

Good point, being able to afford it if those regs were gone.  Anyway to get numbers on that?

By the way, I do house calls

I don't have them off the top of my head, but you ought to be in a position to do a little figuring yourself.

As a physician, how much does it cost you, either in time to do the work yourself, or dollars to hire someone else to do it, to do the paperwork required to treat and bill a Medicaid or Medicare patient?

My guess is that your expenses are not trivial. And we know who ultimately pays the cost of producing a good or service - the consumer.
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RhythmStar

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Re:Medicare RX
« Reply #5 on: November 28, 2003, 12:43:41 pm »

Government regulation certainly increases the cost of R&D in the pharma industry, but I'd wager that medical malpractice liability insurance may have a greater impact on the cost of the physician's fees.  Am I right?

Either way, a totally unregulated market would place no limits at all on medical liability, a major component of a doctor's cost of doing business.  So, it might not be the case that "laissez faire" would lead inexorably towards affordable health care.   Some costs would be reduced or eliminated, others might rise, and the net is anybody's guess, at least for an actual physician's services.

The real affordability potential of total libertarian deregulation of the medical industry would come in the form of self-treatment.  Many common ailments are easily diagnosed with a minimum of information.  With no laws preventing me from doing so, I could simply buy the same amoxicillin for my kid's ear infection that the doctor would charge me to prescribe.   I would still need to go to a clinic for serious injuries, and still need a surgeon or other specialist for some things, but a lot of the routine stuff I could easily handle myself.

RS
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Kyle

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Re:Medicare RX
« Reply #6 on: November 28, 2003, 06:57:01 pm »

Would caps on punitive damages be all that un-libertarian, though?  Certainly there should never be a cap on compensatory damages.  A person should have every dollar he needs to make himself whole again.  But can a court really impose an unlimited fine on me for a slipup, even a minor one?
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RhythmStar

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Re:Medicare RX
« Reply #7 on: November 29, 2003, 12:13:35 pm »

>>are liability caps unlibertarian

Perhaps not.  Liability is a property rights issue, and medical malpractice is the use of force (the medical intervention) in a fraudulent scenario (the doctor represents he's qualified and skilled and subsequently acts in an incompetent or negligent manner).   So, the government's role in this transaction seems on solid ground.

However, I thought the question was 'free markets' being somehow a magical prescription for producing affordable health care.   Affordable drugs for self-treatment?  Perhaps.  Affordable medical care by trained professionals in a modern medical facility?  Not likely.  Affordable to many, sure, but never affordable to all, maybe not even the majority.

RS
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LeopardPM

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Re:Medicare RX
« Reply #8 on: November 30, 2003, 09:38:05 pm »

True, RS - I often fall into that trap of assuming that a cost to the consumer would fall if the governent got out of the way... BUT, what is forgotten is that possibly other services might be considered more viable: perhaps the treatment costs the same, but it is delivered to you in your own home instead - our perhaps better medine
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kater

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Re:Medicare RX
« Reply #9 on: December 01, 2003, 12:00:12 pm »

Thank you for bringing up this topic.  I have a couple of things to say...

First of all, if you're interested in malpractice liability reform (caps, etc.), go to  http://www.aei.org/research/liability/publications/projectID.23,pageID.516/default.asp. There are a couple of papers there with some interesting findings...

In terms of the Medicare bill, for me it really feels like the last straw (again).  We have an unbelievable bunch of pro-regulation, anti-free market, socialist spendthrifts in office, and I'm sick of paying them to redistribute my rather meager wealth.  I do have a heart, and I have some momentary understanding when I hear the words "seniors deserve prescription drug coverage."  But it fails the logic test on so many fronts, and the basis is this: just because you want something doesn't mean you deserve it.  And what seniors really deserve is respect, attention, and loving families--none of which can be delivered by government fiat (no matter what the EU constitution says).

I don't hold any party in high esteem, but this administration should be ashamed to call itself Republican.
« Last Edit: December 01, 2003, 02:40:43 pm by kater »
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bostnfound

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Re:Medicare RX
« Reply #10 on: December 01, 2003, 08:02:33 pm »

Medical Malpractice although certainly increasing the cost of medical care is nothing compared with the amount regulations cost a doctor's office or hospital.  Physicians are required by Federal Law to place medical information into a national databank, supposedly to help understand what maladies are affecting the public.  The average nurse performs 6 hours of paper work a daily and rarely, if ever, sees a patient.  As a result, many more nurses are hired which have no effect on improving medical care, but dramatically increases the overall costs.  This is just another great example on how Washington knows what is best for an industry.
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LeopardPM

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Re:Medicare RX
« Reply #11 on: December 01, 2003, 08:19:59 pm »

what happened to the thread owner? spirochete?
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kater

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Re:Medicare RX
« Reply #12 on: December 02, 2003, 11:38:45 am »

 :-[ I hope I didn't chase him off with my vitriolic response...  I have to keep telling myself, honey not vinegar, honey not vinegar...  

I'm glad to see that a few other people seem interested in the relationship between insurance (government mandated or otherwise) and skyrocketing healthcare costs.  Mixed with the increasingly possible (if ultimately delusional) prospect of living forever, this has us heading for serious trouble.  
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Reaper

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Re:Medicare RX
« Reply #13 on: December 02, 2003, 11:59:38 am »

Yup, those conservative republican "friends of liberty" have brought us the largest new government entitlement since . . . what the New Deal?  or Great Society?
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Reaper
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DadELK68

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Re:Medicare RX
« Reply #14 on: December 09, 2003, 12:57:42 am »

I'm a physician in NH (Derry/Londonderry), and could probably write enough about this sort of thing to bore everyone away from this thread. In fact, I've been putting together a series which is being posted weekly on www.nh-inews.org (there was also a column on the Medicare Bill by Ron Paul, but what does he know? ;)).

IMO, there are good and bad things about the Medicare Bill - the good includes elements which led Ted K and others to call it 'the destruction of Medicare as we know it', the bad includes the fact that it is expansion of a government entitlement.

I'm very interested in the gradual but significant movement toward 'consumer-driven' insurance - there are variations in models, but in general they all involve a form of pre-tax medical savings account and low-premium high-deductible catastrophic insurance coverage. Most cover basic preventive services at some level, and beyond that it's up to the consumer (with certain restrictions to keep it a MEDICAL savings account) to decide where and how the money in their account is best spent.

The results? Patients use a credit card to make payments from their accounts for office visits, tests, treatments and medications. There is no further need for services to bill insurance companies, or for insurance company reviewers and case managers. The physicians and patients become aware of what everything actually costs and grow more concerned with the relative value of goods and services. If they want to choose the name-brand medication which costs ten times as much but does the same thing as the generic or a competitor medication, they can spend their own money to do so (rather than just a copayment with no clue as to what the insurance company ends up paying).

We need to encourage the development and spread of such plans, and work to support allowing individuals (rather than just employers) to deduct the cost of premiums and pay into their own medical savings accounts to break the employer-based insurance model. As market forces are returned to healthcare, lots of imbalances and inefficiencies in the current system will be corrected.

Eric
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