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M&K's Retrievers
05-24-2010, 09:24 AM
According to today's Rasmussen Report, 63% of voters favor repeal of the new Health Care Law.

33% think the Health Care Plan is good for the country which is down 6% from a week ago, This is the lowest level of confidence to date.

It appears that the more people learn about the plan, the less they like it. Just wait until it is actually in place.:(

gman0046
05-24-2010, 09:48 AM
Another example of Obongo trying to take over another American freedom by not allowing us to chose the Health Care program of our choice. I wonder how loud Obongo supporters will scream when Obongo and Holder try to circumvent the Second Amendment and try to disarm law abiding citizens.

Blackstone
05-24-2010, 12:23 PM
Another example of Obongo trying to take over another American freedom by not allowing us to chose the Health Care program of our choice. I wonder how loud Obongo supporters will scream when Obongo and Holder try to circumvent the Second Amendment and try to disarm law abiding citizens.

What are the other American freedoms Obama has tried to take over?

Cody Covey
05-24-2010, 01:13 PM
lookup contract law in regards to the constitution...that should keep you busy a while.

depittydawg
05-24-2010, 02:30 PM
According to today's Rasmussen Report, 63% of voters favor repeal of the new Health Care Law.

33% think the Health Care Plan is good for the country which is down 6% from a week ago, This is the lowest level of confidence to date.

It appears that the more people learn about the plan, the less they like it. Just wait until it is actually in place.:(

I suppose that's the predictable result of a compromise between two extreme positions. Nobody likes the results. Hopefully Obama and the democrats have learned from it (although I doubt it). We don't live in an age where compromise necessarily leads to good decisions or good policy. A better description of our times is "to the victor goes the spoils". In that, Obama has failed badly.

M&K's Retrievers
05-24-2010, 05:10 PM
...... In that, Obama has failed badly.

He has failed miserably in everything except in pissing people off.

cotts135
05-25-2010, 05:56 PM
Another example of Obongo trying to take over another American freedom by not allowing us to chose the Health Care program of our choice. I wonder how loud Obongo supporters will scream when Obongo and Holder try to circumvent the Second Amendment and try to disarm law abiding citizens.


This is a joke......................right. I mean even before healthcare reform choices were extremely limited This legacy employee based health care system that originated in the 30's is still controlled by just a few mega health insurance companies. Choice here is just an illusion

Hew
05-25-2010, 07:44 PM
I suppose that's the predictable result of a compromise between two extreme positions.
LMAO. You're being sarcastic, right? How many Republicans in the House and Senate voted for Obamacare?

Compromise. :rolleyes:

JDogger
05-25-2010, 08:40 PM
LMAO. You're being sarcastic, right? How many Republicans in the House and Senate voted for Obamacare?

Compromise. :rolleyes:

While republican votes for the healthcare bill were negligible, the bill did pass with language inserted with repuplican input. The bill as a whole was somewhat disappointing to those with liberal, secular progressive leanings, whose desire was to see universal, single-payer healthcare inacted.

Oh well, the toe is in the door, and this issue will not soon go away.

Compromise happens, ;-) JD

M&K's Retrievers
05-25-2010, 09:07 PM
Oh well, the toe is in the door, and this issue will not soon go away.



To quote Al from Tool Time, "I don't think so, Tim".

JDogger
05-25-2010, 10:13 PM
To quote Al from Tool Time, "I don't think so, Tim".

Good luck, Mike :p

Hew
05-26-2010, 06:22 AM
While republican votes for the healthcare bill were negligible, no, "negligible" implies "some". There were "none." Not only did no Republicans vote for it, 33 Democrat Reps and 3 Democrat Senators voted against it. the bill did pass with language inserted with repuplican input. That's a canard. The GOP ammendments that were passed were largely procedural and represent a small fraction of the ammendments they offered. The bill as a whole was somewhat disappointing to those with liberal, secular progressive leanings, whose desire was to see universal, single-payer healthcare inacted.
...................

JDogger
05-26-2010, 05:32 PM
Oh, yeah. I forgot about Snowe's flip-flop.:oops:

M&K's Retrievers
06-01-2010, 09:09 AM
More fuel to the fires of repeal:

http://news.yahoo.com/s/nm/20100531/hl_nm/us_health_3

YardleyLabs
06-01-2010, 09:19 AM
More fuel to the fires of repeal:

http://news.yahoo.com/s/nm/20100531/hl_nm/us_health_3
Three things:

Canada is facing major issues with health care costs. Their problem is that their costs are increasing at less than half the rate of ours and that they spend half as much of their GDP on health care as we do! Let's work hard to protect our ability to have costs going up 2-3 times the rate of theirs.
The Canadian model, like the British model, makes the government the primary direct supplier of health services. That is a model that we rejected -- rightly or wrongly (I believe rightly).
There is no situation that I envision in which repeal would have the slightest chance of passing before 2013.

Gerry Clinchy
06-03-2010, 09:37 AM
http://www.nytimes.com/2010/06/03/business/03dartmouth.html?th&emc=th

Basically, this article talks about how the Dartmouth Group was cited as the source for data that better health care was available at lower cost. This premise was used by proponents of Obamacare as why billions could be saved by "rewarding" efficient care givers. The data did not include provisions for differences in cost of living in different areas.

However, Dartmouth Group, itself, is stating that their data only relates to costs ... not quality of care.


A main focus of the Dartmouth Atlas is comparing spending among the nation’s hospitals. To do that, Dartmouth researchers use data on how much hospitals have billed Medicare for patients with a chronic illness who were in their last six months or two years of life.


But the atlas’s hospital rankings do not take into account care that prolongs or improves lives. If one hospital spends a lot on five patients and manages to keep four of them alive, while another spends less on each but all five die, the hospital that saved patients could rank lower because Dartmouth compares only costs before death.

“It may be that some places that are spending more are actually getting better results,” said Dr. Harlan M. Krumholz, a professor of medicine and health policy expert at Yale (http://topics.nytimes.com/top/reference/timestopics/organizations/y/yale_university/index.html?inline=nyt-org).

Failing to receive credit for better care enrages some hospital administrators. But for the Dartmouth researchers, making these administrators uncomfortable is the point of the rankings.

“When you name names, people start paying more attention,” Dr. Fisher said. “We never asserted and never claimed that we judged the quality of care at a hospital — only the cost.”

This last paragraph "enrages" me because it asserts that it is okay to draw attention to certain providers by giving misleading/incomplete information!


Still, the Dartmouth work remains influential in Washington.

Dr. Donald Berwick, nominated by President Obama (http://topics.nytimes.com/top/reference/timestopics/people/o/barack_obama/index.html?inline=nyt-per) to run Medicare, called it the most important research of its kind in the last quarter-century. In March, in response to the Congressional Democrats who would have otherwise withheld their support for the health legislation, the administration made a promise. It said it would ask the Institute of Medicine (http://topics.nytimes.com/top/reference/timestopics/organizations/i/institute_of_medicine/index.html?inline=nyt-org), a nongovernment advisory group, to consider ways of putting the Dartmouth findings into action by setting payment rates that would punish inefficient hospitals and reward efficient ones.


Then this incomplete data was the basis for influencing voting on the HC bill! ... even when the data was possibly misleading in many instances.



But the real difference in costs between, say, Houston and Bismarck, N.D., may result less from how doctors work than from how patients live. Houstonians may simply be sicker and poorer than their Bismarck counterparts. Also, nurses in Houston tend to be paid more than those in North Dakota because the cost of living is higher in Houston. Neither patients’ health nor differences in prices are fully considered by the Dartmouth Atlas.




The mistaken belief that the Dartmouth research proves that cheaper care is better care is widespread — and has been fed in part by Dartmouth researchers themselves.
The debate about the Dartmouth work is important because a growing number of health policy researchers are finding that overhauling the nation’s health care system will be far harder and more painful than the Dartmouth work has long suggested. Cuts, if not made carefully, could cost lives.


In fact, among health policy analysts, that battle has already begun. Critiques have been published in prominent medical journals, and more are on the way.



They say their critics fail to understand the issues and often make significant statistical errors. And they say even if they adjusted more fully to reflect differences in regional costs and patients’ health, the overall effect on the atlas’s findings would be relatively small.


How do they know this until they actually do it?



But even those who defend Dartmouth say that failing to make basic data adjustments undermines the geographic variations the atlas purports to show. David Cutler, a professor of economics at Harvard (http://topics.nytimes.com/top/reference/timestopics/organizations/h/harvard_university/index.html?inline=nyt-org), likens it to failing to account for inflation when looking at gross domestic product (http://topics.nytimes.com/top/reference/timestopics/subjects/u/united_states_economy/gross_domestic_product/index.html?inline=nyt-classifier). “Nobody in their right mind would talk about G.D.P. growth without adjusting for prices,” he said.




In addition to their hospital rankings, the Dartmouth researchers have also done separate studies of how Medicare spending affects patient care regionally. A 2003 study (http://www.annals.org/content/138/4/273.full) found that patients who lived in places most expensive for the Medicare program received no better care than those who lived in cheaper areas.
Because some regions spent nearly a third more than other regions without any apparent benefit, the Dartmouth team concluded that at least one dollar in three was wasted by Medicare. When applied generally to the nation’s health care system, that meant about $700 billion could be saved.

So nurses in NYC give the same care to Medicare patients as nurses do in Arkansas. However, the nurses in NYC certainly receive higher wages than those in Arkansas. So, you'll save money by taking money away from NYC requiring wage cuts ... and the nurses will have to move to Arkansas to earn a living? I'd guess that it wouldn't take long for the Medicare patients in NYC to suffer the consequences of a nursing shortage.



But as it began publicly discussing its research, the Dartmouth team often extrapolated beyond this basic finding. Not only do high-spending regions fail to provide better care, the Dartmouth team began to argue, but those regions actually offer worse care.
In just one example of this extrapolation, Dr. Fisher, in testimony before Congress last year, summarized his and others’ work by asking, “Why are access and quality worse in high-spending regions?”
And on Dartmouth’s Web site, a question-and-answer section suggests that this interpretation is appropriate:
“The evidence is that higher utilization does not extend life expectancy, and might be correlated with shorter life expectancy, compared with lower utilization. Therefore, sending people with chronic diseases to higher-efficiency, lower-utilization hospitals for their care could result in both lower spending and increased quality and length of life.”




While a few studies by other researchers have shown that more spending leads to worse health, some others have suggested the opposite — that more expensive hospitals might offer better care. But many have shown no link, either way, between spending and quality.
In other words, there is little evidence to support the widely held view, shaped by the Dartmouth researchers, that the nation’s best hospitals tend to be among the least expensive.
In interviews, Dr. Fisher and Mr. Skinner acknowledged that there was no proven link between greater spending and worse health outcomes. And Dr. Fisher acknowledged the apparent inconsistency between his statements in interviews with The New York Times and those made elsewhere, saying that he was sometimes less careful in discussing his team’s research than he should be.

Does this mean that the votes in Congress were influenced by a research group whose claims were specious?

[more]

Gerry Clinchy
06-03-2010, 09:38 AM
In any case, the more-is-worse message has resonated with insurers, whose foundations now help to finance the Dartmouth Atlas. Dartmouth researchers also created a company, Health Dialog, to consult for insurers and others on Dartmouth’s findings. Valued at nearly $800 million, the company was sold to a British insurer in 2007 and still helps to finance the Dartmouth work.


The insurance companies, with the new HC reform, would have a large interest in having a reason to pay out less on claims ... as they will be taking on larger costs by eliminating pre-existing conditions. Nothing in the status quo basically changes here ... those paying for their own care, or who don't need or use as much care, will still be paying for those who need more care since providers will get paid less by the insurors ... based on misleading data. Since there will be more people who will fall into the "more care" category (with the inclusion of pre-existing conditions), the overall gap that the less-care category needs to fill will be larger.

Nobody would argue that those with pre-existing conditions need a way to get health care ... but I'd rather have someone tell me the truth than try to disseminate misleading data for a temporary "feel good" that will soon enough be proven ephermeral.

Rating hospitals in Green Bay, WI:

Two of Green Bay’s hospitals, Bellin and St. Mary’s Hospital Medical Center, rank fourth and 11th within Wisconsin on the Dartmouth list.

But again, Dartmouth ranks hospitals only by costs and number of treatments and procedures. A different picture emerges from work done by the Wisconsin Collaborative for Healthcare Quality, a voluntary group of health care organizations that uses both price and quality of care measures. In an analysis of heart attack (http://health.nytimes.com/health/guides/disease/heart-attack/overview.html?inline=nyt-classifier) care, for example, it ranks Bellin second, and St. Mary’s 15th, among the 22 hospitals in the state.


And a Medicare ranking based on its own data that shows how many people die after treatment for certain conditions — statistics that exclude costs entirely — puts Bellin fifth, but drops St. Mary’s to second-to-last: 67th of the 68 hospitals statewide that were measured by both Dartmouth and Medicare.


Similar problems arise with Dartmouth’s regional data. In Dartmouth’s rankings, for instance, New Jersey comes in dead last because its costs per Medicare beneficiary are the nation’s highest. And yet, for the quality of care offered in New Jersey, independent of cost, federal health officials rank New Jersey second only to Vermont.


“For the past 20 years, my colleagues and I and now many others have been working hard to clarify the causes and consequences of regional variations in practice and spending,” Dr. Fisher said. “The work is challenging and more work needs to be done, but we have learned enough to help guide health reform.”

I guess that last statement might be true depending on what the "agenda" is.

What happens when this $700 billion in "savings" does not materialize (because the data was faulty)? This appears to be the $500 billion (in savings) that was removed from Medicare funding. This reduction in Medicare funding was then used to estimate the overall cost of the HC reform.

I'd say we should be prepared for the cost of this HC reform bill to cost an extra $1/2 trillion ... or 50% more than was the "selling price" to Congress to get the bill passed.

The real question will be whether it accomplishes the desired end ... to give affordable, quality health care to more people. It may end up just being a trade-off, i.e. getting care, or more care, for some & less for others.

M&K's Retrievers
06-03-2010, 10:25 AM
Bend over. The cost will be unbelievable. I've said it here before. The number of uninsureds will likely double rather than decrease under obamacare.