What Could Possibly Go Wrong?

[Kathianne]

http://www.latimes.com/health/la-me-doctors-20130210,0,1509396.story


State lacks doctors to meet demand of national healthcare law Lawmakers are working on proposals that would enable physician assistants, nurse practitioners, optometrists and pharmacists to diagnose, treat and manage some illnesses.
SACRAMENTO — As the state moves to expand healthcare coverage to millions of Californians under President Obama (http://www.latimes.com/topic/politics/government/barack-obama-PEPLT007408.topic)'s healthcare law, it faces a major obstacle: There aren't enough doctors to treat a crush of newly insured patients.


Some lawmakers want to fill the gap by redefining who can provide healthcare.


They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes (http://www.latimes.com/topic/health/diseases-illnesses/diabetes-HEDAI0000022.topic) and high-blood pressure (http://www.latimes.com/topic/health/physical-conditions/high-blood-pressure-HEPHC0000023.topic).

...




I mean Medicare is already so 'graft free.' right?

http://www2.wkrg.com/news/2013/feb/06/you-ask-we-investigate-medicare-fraud-mobile-ar-5536994/

http://www.journalnow.com/news/state_region/article_4ec7a7f0-7066-11e2-b9b4-001a4bcf6878.html

http://video.foxbusiness.com/v/2141985503001/medicare-fraud-and-the-russian-mob/

http://seniorhousingnews.com/2013/02/05/doctor-involved-in-nursing-home-medicare-fraud-case-settles-for-700000/

http://theadvocate.com/home/5074932-125/couple-sentenced-in-medicare-fraud

These are just recent stories, the problems with Medicare, not to mention Medicaid go back decades. Exactly how is Obamacare going to prevent such on a much larger scale?

[logroller]

Does anybody really not know the cause of hypertension and diabetes? We know how to prevent it--diet and exercise--and just don't. You don't need a doctor to prescribe a pill that literally has been prescribed millions of times for the same symptoms; any experienced medical professional knows the ins and outs of treating epidemic disease; the key is finding ways to increase prevention, not treatment. That needs to be the focus of healthcare regardless of doctor to patient ratios.

[bingster]

http://www.latimes.com/health/la-me-doctors-20130210,0,1509396.story



I mean Medicare is already so 'graft free.' right?

http://www2.wkrg.com/news/2013/feb/06/you-ask-we-investigate-medicare-fraud-mobile-ar-5536994/

http://www.journalnow.com/news/state_region/article_4ec7a7f0-7066-11e2-b9b4-001a4bcf6878.html

http://video.foxbusiness.com/v/2141985503001/medicare-fraud-and-the-russian-mob/

http://seniorhousingnews.com/2013/02/05/doctor-involved-in-nursing-home-medicare-fraud-case-settles-for-700000/

http://theadvocate.com/home/5074932-125/couple-sentenced-in-medicare-fraud

These are just recent stories, the problems with Medicare, not to mention Medicaid go back decades. Exactly how is Obamacare going to prevent such on a much larger scale?

This happens every few years and that's why the medical field is booming right now. Ten years ago, we had to pay double for contract pharmacists because there was a shortage in pharmacists-now there's too many. Technicians usually take on more during shortages, this is not an unusual story. Hopefully the increases in doctor jobs will make up for the losses in less skilled medical jobs that have been blamed on Obamacare.

[Kathianne]

This happens every few years and that's why the medical field is booming right now. Ten years ago, we had to pay double for contract pharmacists because there was a shortage in pharmacists-now there's too many. Technicians usually take on more during shortages, this is not an unusual story. Hopefully the increases in doctor jobs will make up for the losses in less skilled medical jobs that have been blamed on Obamacare.

I'm not surprised anymore, the point flew right over your head. Waste and corruption are the signposts of federal programs in general, entitlements in particular. What has been overwhelming corruption in the relatively 'small' Medicare arena, is about to blossom under Obamacare.

[jimnyc]

This law, when it kicks in, is only going to effect the little people, US. I've said this a thousand times now. Doctors and businesses aren't going to sit back and simply take losses. They will raise prices, reduce workforce and make whatever changes necessary to makeup the difference. 99 out of 100 times that cost is made up by passing on increased costs and such to the consumer. Those in charge at these businesses would be remiss of their duties if they didn't do this, it's simply common sense.

[Kathianne]

This law, when it kicks in, is only going to effect the little people, US. I've said this a thousand times now. Doctors and businesses aren't going to sit back and simply take losses. They will raise prices, reduce workforce and make whatever changes necessary to makeup the difference. 99 out of 100 times that cost is made up by passing on increased costs and such to the consumer. Those in charge at these businesses would be remiss of their duties if they didn't do this, it's simply common sense.

and health care is going to get worse, not better. Indeed, one may be better off on their own. Now comes the fact that the government is looking to make 'legal' others to diagnose and give treatments. Dentists, optometrists, nurses, etc. I mean they all know 'something' about science, right?

[aboutime]

This happens every few years and that's why the medical field is booming right now. Ten years ago, we had to pay double for contract pharmacists because there was a shortage in pharmacists-now there's too many. Technicians usually take on more during shortages, this is not an unusual story. Hopefully the increases in doctor jobs will make up for the losses in less skilled medical jobs that have been blamed on Obamacare.



Yeah. Sure bingster. You keep thinking that. Keep trying to convince yourself how great things are Through Your Rose Colored Obama glasses.

We all know. You have no intentions of listening to us, paying attention to us, or giving us any credit for being right. So. Instead. Like those millions of others who voted for Obama Once, or Twice.

Don't you dare change anything. Stay just as you are.
Sometimes. You deserve what you ask for. And you're gonna get it.

Meanwhile. Keep hoping you never become seriously ill, or injured and expect INSTANT medical services for free to bend over backward to treat you.

[fj1200]

http://www.latimes.com/health/la-me-doctors-20130210,0,1509396.story


Lawmakers are working on proposals that would enable physician assistants, nurse practitioners, optometrists and pharmacists to diagnose, treat and manage some illnesses.

I don't have a problem with it. If some experienced practitioners have the ability to handle some appointments, under a doctor's supervision, then it should control some costs and allow doctors to specialize in the more difficult cases. Someone at church today was talking about their bronchitis, I can imagine that someone other than a doctor has the ability to make some rudimentary diagnoses. Our kids have primarily seen a nurse practitioner and I completely trust her abilities and don't see the need to see the doctor for the required check ups.

[aboutime]

I don't have a problem with it. If some experienced practitioners have the ability to handle some appointments, under a doctor's supervision, then it should control some costs and allow doctors to specialize in the more difficult cases. Someone at church today was talking about their bronchitis, I can imagine that someone other than a doctor has the ability to make some rudimentary diagnoses. Our kids have primarily seen a nurse practitioner and I completely trust her abilities and don't see the need to see the doctor for the required check ups.


Good for you. Just wait till someone connected with govt, and Obamacare makes it too expensive for Licensed Physicians to remain in business, letting practicioners, nurses, and physician assistants fend for themselves without Licensed Dr. administration. You can't forget. All of the people who work for doctors..are also human beings with the same kinds of problems their patients have.

If it doesn't create a problem for you. Then YOU are part of the problems, not the solutions.
I know you won't pay attention to me. But then. That's how you will have to learn how serious a problem is...personally, before you finally say to yourself. "I should have listened, and paid attention."

[fj1200]

Good for you. Just wait till someone connected with govt, and Obamacare makes it too expensive for Licensed Physicians to remain in business, letting practicioners, nurses, and physician assistants fend for themselves without Licensed Dr. administration. You can't forget. All of the people who work for doctors..are also human beings with the same kinds of problems their patients have.

If it doesn't create a problem for you. Then YOU are part of the problems, not the solutions.
I know you won't pay attention to me. But then. That's how you will have to learn how serious a problem is...personally, before you finally say to yourself. "I should have listened, and paid attention."

WTF are you even talking about? Where did I mention support for ACA?

[aboutime]

WTF are you even talking about? Where did I mention support for ACA?


Better yet. Where did I mention anything about support for ACA?

Show me!

[Tyr-Ziu Saxnot]

I don't have a problem with it. If some experienced practitioners have the ability to handle some appointments, under a doctor's supervision, then it should control some costs and allow doctors to specialize in the more difficult cases. Someone at church today was talking about their bronchitis, I can imagine that someone other than a doctor has the ability to make some rudimentary diagnoses. Our kids have primarily seen a nurse practitioner and I completely trust her abilities and don't see the need to see the doctor for the required check ups.

There is a reason why nurses and doctors ARE COMPENSATED AT DIFFERENT RATES.
The point so often made about the quality of care going down is highlighted by that which you so casually accept as being fine. Fine for cutting costs but not so fine for saving lives and increasing the quality of a healthy life IMHO.-TYR

[fj1200]

Better yet. Where did I mention anything about support for ACA?

Show me!

I'd be shocked if anyone knew WTF you were talking about.


There is a reason why nurses and doctors ARE COMPENSATED AT DIFFERENT RATES.
The point so often made about the quality of care going down is highlighted by that which you so casually accept as being fine. Fine for cutting costs but not so fine for saving lives and increasing the quality of a healthy life IMHO.-TYR

Of course they're compensated at different rates. I don't accept your premise that the quality of care is going down besides the fact that I wasn't making any comment on ACA at all rather that it makes sense to free up qualified people to be able to make diagnoses and decisions. You do realize that much of what doctors and nurses do now is based on government restrictions don't you? Are you now in favor of government regulation?

[Kathianne]

I don't have a problem with it. If some experienced practitioners have the ability to handle some appointments, under a doctor's supervision, then it should control some costs and allow doctors to specialize in the more difficult cases. Someone at church today was talking about their bronchitis, I can imagine that someone other than a doctor has the ability to make some rudimentary diagnoses. Our kids have primarily seen a nurse practitioner and I completely trust her abilities and don't see the need to see the doctor for the required check ups.

While not all docs are created equal, I'm sort of concerned with someone not being able to tell the difference between bronchitis and tuberculosis. One is aware that the former is making a comeback, no?

[fj1200]

While not all docs are created equal, I'm sort of concerned with someone not being able to tell the difference between bronchitis and tuberculosis. One is aware that the former is making a comeback, no?

I would think that any in the health field would be aware of those things especially if responsibilities are expanded. The key is managing "some" illnesses.

[Kathianne]

I would think that any in the health field would be aware of those things especially if responsibilities are expanded. The key is managing "some" illnesses.

Then again, look at what has gone before. Look at those that are trained and still miss. A disaster waiting.

[Tyr-Ziu Saxnot]

Of course they're compensated at different rates. I don't accept your premise that the quality of care is going down besides the fact that I wasn't making any comment on ACA at all rather that it makes sense to free up qualified people to be able to make diagnoses and decisions. You do realize that much of what doctors and nurses do now is based on government restrictions don't you? Are you now in favor of government regulation?

Accept it or not my point stands. Giving far more duties and responsibilities to lesser trained people (nurses) will lower the quality of care. Government will ride that horse into the ground here even faster than they have in other countries.
I am certainly not in favor of government regulations when I hold that the current obamacare fiasco is Unconstitutional crap rammed down out collective throats.-Tyr

[fj1200]

Then again, look at what has gone before. Look at those that are trained and still miss. A disaster waiting.

I'm not sure what that even means. They're not going to be doing brain surgery.


Accept it or not my point stands. Giving far more duties and responsibilities to lesser trained people (nurses) will lower the quality of care. Government will ride that horse into the ground here even faster than they have in other countries.
I am certainly not in favor of government regulations when I hold that the current obamacare fiasco is Unconstitutional crap rammed down out collective throats.-Tyr

I disagree. Do you think you get great care with minimal time with a doctor or more time with a nurse. If I am more likely to get a quick appointment with a PA for something that I wouldn't take the time to see a doctor with my quality of care just went up. But I know you're only in favor of regulations that you think benefit you and will loathe anything even closely connected to ACA.

[Kathianne]

I'm not sure what that even means. They're not going to be doing brain surgery.



I disagree. Do you think you get great care with minimal time with a doctor or more time with a nurse. If I am more likely to get a quick appointment with a PA for something that I wouldn't take the time to see a doctor with my quality of care just went up. But I know you're only in favor of regulations that you think benefit you and will loathe anything even closely connected to ACA.

Simple enough. Trained MD's have often misdiagnosed obvious signs of disease. Why? Outside of their specialty, thus the warnings to women not to have an ob/gyn as primary doc. Now the gov't is saying that some ijit with 2 years of ophthalmology training should be referring people for cancer or by-pass surgery? No thanks.

[Tyr-Ziu Saxnot]

I'm not sure what that even means. They're not going to be doing brain surgery.



I disagree. Do you think you get great care with minimal time with a doctor or more time with a nurse. If I am more likely to get a quick appointment with a PA for something that I wouldn't take the time to see a doctor with my quality of care just went up. But I know you're only in favor of regulations that you think benefit you and will loathe anything even closely connected to ACA.

I have two great doctors and one great nurse. I applaud all three of them for their abilities. Its not a matter of my thinking in selfish terms. I see what government mandated and controlled healthcare has done in other countries, Britain being a great example of how it degrades the quality of care. And obamacare will be by far the biggest and worst ran one .. How many people will it cause to die prematurely?? Nobody knows but odds are many if Britain's example prove to be magnified here in this new system . I didn't fight to live this damn long to be ffed over and killed prematurely by a government operated boondoggle.. Judging by how ffed up and corrupted other government ran programs are this one stands to be a real monster..-Tyr

[fj1200]

Simple enough. Trained MD's have often misdiagnosed obvious signs of disease. Why? Outside of their specialty, thus the warnings to women not to have an ob/gyn as primary doc. Now the gov't is saying that some ijit with 2 years of ophthalmology training should be referring people for cancer or by-pass surgery? No thanks.

That "ijit" would be referring, not handling.


I have two great doctors and one great nurse. I applaud all three of them for their abilities. Its not a matter of my thinking in selfish terms. I see what government mandated and controlled healthcare has done in other countries, Britain being a great example of how it degrades the quality of care. And obamacare will be by far the biggest and worst ran one .. How many people will it cause to die prematurely?? Nobody knows but odds are many if Britain's example prove to be magnified here in this new system . I didn't fight to live this damn long to be ffed over and killed prematurely by a government operated boondoggle.. Judging by how ffed up and corrupted other government ran programs are this one stands to be a real monster..-Tyr

Are you under some sort of impression that I'm having an ACA discussion here? But I know, you like your regulation like it is. It also seems that you have missed that some parts of CA are having massive Dr. shortages already and wait times are quite long; all this before ACA.

[logroller]

Better yet. Where did I mention anything about support for ACA?Show me!As you wish.
Obamacare...If it doesn't create a problem for you. Then YOU are part of the problems, not the solutions. FJ said that, in the instance of the op, it didn't create problems for him; so you then consider him to be part of the problem, i.e. supporting ACA, and not part of the solution, i.e. opposing ACA. Pretty sad that even you don't know wtf you're talking about.

[aboutime]

Time to convince California, and LA residents how great OBAMACARE is, or will be?

http://www.latimes.com/health/la-me-doctors-20130210,0,1509396.story

[aboutime]

As you wish. FJ said that, in the instance of the op, it didn't create problems for him; so you then consider him to be part of the problem, i.e. supporting ACA, and not part of the solution, i.e. opposing ACA. Pretty sad that even you don't know wtf you're talking about.


COMPLACENCY Is part of the problem. Almost like saying..."It doesn't affect me, so Not a problem!"

[fj1200]

COMPLACENCY Is part of the problem. Almost like saying..."It doesn't affect me, so Not a problem!"

Seems to be the prevailing attitude in this thread doesn't. "My doctors are cool so let's not go addressing massive shortages; current and future."

[Tyr-Ziu Saxnot]

Are you under some sort of impression that I'm having an ACA discussion here? But I know, you like your regulation like it is. It also seems that you have missed that some parts of CA are having massive Dr. shortages already and wait times are quite long; all this before ACA.

Its not a question of my liking current regulations . Its more a fact that I've researched and seen how much of a total disaster other government ran healthcare systems have been!! Why are you and so many others ignoring this behemoth? Also why is there not far more concern and information forthcoming about this massive rise in future costs? The entire thing is a corrupt and dangerous action forced upon the American people. If the whole is rotten then by default the many parts of that whole are as well.
What am I too say should it cause my mother's death prematurely? Is it , "well but she had a great nurse"!!??
Or , "man sure didnt cost her much"?? --Tyr

[fj1200]

Its not a question of my liking current regulations . Its more a fact that I've researched and seen how much of a total disaster other government ran healthcare systems have been!! Why are you and so many others ignoring this behemoth? Also why is there not far more concern and information forthcoming about this massive rise in future costs? The entire thing is a corrupt and dangerous action forced upon the American people. If the whole is rotten then by default the many parts of that whole are as well.
What am I too say should it cause my mother's death prematurely? Is it , "well but she had a great nurse"!!??
Or , "man sure didnt cost her much"?? --Tyr

:rolleyes: Your "research" is legendary.


Are you under some sort of impression that I'm having an ACA discussion here?

You clearly like what's current and ignore that CA already has serious shortages. And please point out where individuals will NOT have a doctor. I'm also amused that you seem to think what we have is NOT government run healthcare.

[Tyr-Ziu Saxnot]

:rolleyes: Your "research" is legendary.



You clearly like what's current and ignore that CA already has serious shortages. And please point out where individuals will NOT have a doctor. I'm also amused that you seem to think what we have is NOT government run healthcare.


I am amused that you seem to think full implementation of obamacare is not folly laced with stupidity compounded by ignorance!
Try researching other such systems in other nations. You could start with Britain for example. The fact that you ignore such presented by me reveals a clear lack of honesty in approaching this subject IMHO.
For with the example of the healthcare system Britain has Drummond has repeatedly given examples of its corruption, wastefulness and low quality of care along with its ever increasing wait times for patients to even be seen by a doctor.
There are loads of information on the negatives of such government systems and stop pretending that its in full effect now .
We get it , you think it's great , just don't think that your happiness will infect we that know better, ok?.;)-Tyr

[logroller]

I am amused that you seem to think full implementation of obamacare is not folly laced with stupidity compounded by ignorance!
Try researching other such systems in other nations. You could start with Britain for example. The fact that you ignore such presented by me reveals a clear lack of honesty in approaching this subject IMHO.
For with the example of the healthcare system Britain has Drummond has repeatedly given examples of its corruption, wastefulness and low quality of care along with its ever increasing wait times for patients to even be seen by a doctor.
There are loads of information on the negatives of such government systems and stop pretending that its in full effect now .
We get it , you think it's great , just don't think that your happiness will infect we that know better, ok?.;)-Tyr
Cherry picked research is hardly evidentiary. Check out Switzerland. Or Japan. How do those differ from the UK, what do they share? What unique aspects cater to the respective successes and failures? If i was going to reject every system that showed corruption and fraud we'd have no healthcare. You point to something (low doctor:patient ratios) and say look at whats going on, but those things were already there before ACA; so your conclusion that ACA and Obama are the problem is unsupported and you then become, as aboutime would say, part of the problem for your failure to address the actual problem.

[fj1200]

I am amused that you seem to think full implementation of obamacare is not folly laced with stupidity compounded by ignorance!
Try researching other such systems in other nations. You could start with Britain for example. The fact that you ignore such presented by me reveals a clear lack of honesty in approaching this subject IMHO.
For with the example of the healthcare system Britain has Drummond has repeatedly given examples of its corruption, wastefulness and low quality of care along with its ever increasing wait times for patients to even be seen by a doctor.
There are loads of information on the negatives of such government systems and stop pretending that its in full effect now .
We get it , you think it's great , just don't think that your happiness will infect we that know better, ok?.;)-Tyr

If that's what you think then your reading comprehension is abysmally ignorant or you just read what you wish to read because as I said repeatedly here I was making no argument about ACA. And FWIW you have presented nothing, I am fully aware that GB has a horrible system but there are others, as LR points out, that have better success. I can understand how you aren't able to separate ACA with other changes that were seemingly needed in CA even ahead of ACA implementation but there are those who don't have automatic knee-jerk responses when we see 'Obamacare' in a story.

So before you blather more ignorance about how I "think it's great" you might want to do some actual research and find out what I really think about ACA not just some imaginary position that you create in your head.

[Marcus Aurelius]

Does anybody really not know the cause of hypertension and diabetes? We know how to prevent it--diet and exercise--and just don't. You don't need a doctor to prescribe a pill that literally has been prescribed millions of times for the same symptoms; any experienced medical professional knows the ins and outs of treating epidemic disease; the key is finding ways to increase prevention, not treatment. That needs to be the focus of healthcare regardless of doctor to patient ratios.

Diet and exercise alone do not always control these diseases. They are also not always the only factors involved. Genetics plays a large roll too.

[logroller]

Diet and exercise alone do not always control these diseases. They are also not always the only factors involved. Genetics plays a large roll too.
is it linked, sure; with diabetes more so than heart disease, but lifestyle factors one has the abitity to change.
There is an irrefutable link between diet and exercise that genetics alone does not explain.
Genes alone are not enough. One proof of this is identical twins. Identical twins have identical genes. Yet when one twin has type 1 diabetes, the other gets the disease at most only half the time. When one twin has type 2 diabetes, the other's risk is at most 3 in 4...If you have a family history of type 2 diabetes, it may be difficult to figure out whether your diabetes is due to lifestyle factors or genetic susceptibility. Most likely it is due to both. However, don’t lose heart. Studies show that it is possible to delay or prevent type 2 diabetes by exercising and losing weight.
http://m.diabetes.org/diabetes-basics/genetics-of-diabetes.html

And heart disease..

Two large studies from Northwestern Medicine confirm a healthy lifestyle has the biggest impact on cardiovascular health. One study shows the majority of people who adopted healthy lifestyle behaviors in young adulthood maintained a low cardiovascular risk profile in middle age. The five most important healthy behaviors are not smoking, low or no alcohol intake, weight control, physical activity and a healthy diet. The other study shows cardiovascular health is due primarily to lifestyle factors and healthy behavior, not heredity.http://www.northwestern.edu/newscenter/stories/2010/11/heart-disease.html

genes matter but if you're a slug, the odds are against you.

[Kathianne]

I don't have a problem with it. If some experienced practitioners have the ability to handle some appointments, under a doctor's supervision, then it should control some costs and allow doctors to specialize in the more difficult cases. Someone at church today was talking about their bronchitis, I can imagine that someone other than a doctor has the ability to make some rudimentary diagnoses. Our kids have primarily seen a nurse practitioner and I completely trust her abilities and don't see the need to see the doctor for the required check ups.

I don't have a problem with a set up like you are referring to either. However, when the government steps in, that's when things get messed up. Suddenly one may find oneself with a very sick child, being told that they WILL see the nurse practitioner, who may not be the same one you trust completely. Your options may be closed.

[fj1200]

I don't have a problem with a set up like you are referring to either. However, when the government steps in, that's when things get messed up. Suddenly one may find oneself with a very sick child, being told that they WILL see the nurse practitioner, who may not be the same one you trust completely. Your options may be closed.

I certainly have no faith when the government "steps in" but I see this as the government "stepping out" in a sort of deregulation. As of this point they have no authority to decide who you WILL see.

[Kathianne]

I certainly have no faith when the government "steps in" but I see this as the government "stepping out" in a sort of deregulation. As of this point they have no authority to decide who you WILL see.

and you see this lasting just how long?

[fj1200]

and you see this lasting just how long?

:dunno: Government can screw anything up at any time. I don't see this as a stepping stone though.

[Kathianne]

:dunno: Government can screw anything up at any time. I don't see this as a stepping stone though.

I do and here's why; there have been calls for years to allow nurse anesthetists, midwives, etc., throughout the country, only a few states allowed. That was on the STATE level. Suddenly the tax monster decides that optometrists, dentists, etc., are going to be 'just fine' as alternatives to docs. I guess the guys at 4 eyes can take a Saturday course for credit resulting in 'caring for the common cold,' and be able to bill the government.

Great idea! it's the reason I posted the related Medicare scandals, all within the past few months.

[bingster]

I'm not surprised anymore, the point flew right over your head. Waste and corruption are the signposts of federal programs in general, entitlements in particular. What has been overwhelming corruption in the relatively 'small' Medicare arena, is about to blossom under Obamacare.

Like there's no waste and corruption in the private sector?

This federal program requires everyone to buy there own insurance. This is forcing demand up in the medical fields so they are experiencing shortages. What part of this is bad for business?

As for quality, I was referring to what happens in the pharmacy business and will happen in the rest of the medical profession. Doctors will still make important decisions, but lesser tasks will be delegated down. Mistakes could happen, but it's not worth a panic.

[bingster]

I do and here's why; there have been calls for years to allow nurse anesthetists, midwives, etc., throughout the country, only a few states allowed. That was on the STATE level. Suddenly the tax monster decides that optometrists, dentists, etc., are going to be 'just fine' as alternatives to docs. I guess the guys at 4 eyes can take a Saturday course for credit resulting in 'caring for the common cold,' and be able to bill the government.

Great idea! it's the reason I posted the related Medicare scandals, all within the past few months.

This is at the state level.

[Trigg]

As for quality, I was referring to what happens in the pharmacy business and will happen in the rest of the medical profession. Doctors will still make important decisions, but lesser tasks will be delegated down. Mistakes could happen, but it's not worth a panic.

You need to do your research on physician assistants and nurse practitioners.

You also might want to look at the physician shortage.

Then you can pull up stories regarding both in Europe. If you have any questions I will post what my sisters goes through in Finland with their 'FREE healthcare

[Kathianne]

This is at the state level.

What is being considered is federal, part of Obamacare. It may be administered by states, but the mandate would be federal.

[fj1200]

Like there's no waste and corruption in the private sector?

The difference between private and public? Accountability.


What is being considered is federal, part of Obamacare. It may be administered by states, but the mandate would be federal.

This isn't Federal. This is California's response to shortages, already being realized and expected.

[SassyLady]

This happens every few years and that's why the medical field is booming right now. Ten years ago, we had to pay double for contract pharmacists because there was a shortage in pharmacists-now there's too many. Technicians usually take on more during shortages, this is not an unusual story. Hopefully the increases in doctor jobs will make up for the losses in less skilled medical jobs that have been blamed on Obamacare.

What do you think is happening with all of our current doctors? Most of them will be retiring and/or quitting and there just isn't enough doctors to fill the void and influx of new patients that will come in under Obamacare. CA has huge shortage of doctors willing to take Medicare patients. Did you know they are going to make Pharmacists and Optometrists available for Primary Care, as well as Nurse Practioners and perhaps Orthodontists? I don't think I want to have my Pharmacists giving me an annual exam!




As the state moves to expand healthcare coverage to millions of Californians under President Obama's healthcare law, it faces a major obstacle: There aren't enough doctors to treat a crush of newly insured patients. ...
Currently, just 16 of California's 58 counties have the federal government's recommended supply of primary care physicians, with the Inland Empire and the San Joaquin Valley facing the worst shortages. In addition, nearly 30% of the state's doctors are nearing retirement age, the highest percentage in the nation, according to the Assn. of American Medical Colleges.

State officials' first instinct isn't unreasonable: To ease occupational licensing barriers so that other health-care providers can do more to deal with the shortage.
They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure.



more.......


But, are those nurse practitioners and pharmacists going to be any happier than physicians with expanded Medicaid?
Last year, a Physicians Foundation survey (http://reason.com/blog/2012/10/02/doctors-agree-their-jobs-suck-and-the-go) found that 26 percent of physicians had closed their practices to Medicaid patients because of concerns over compensation and red tape. Kaiser says the number of doctors turning away Medicaid patients is closer to a third (http://www.kaiserhealthnews.org/stories/2012/august/06/third-of-medicaid-doctors-say-no-new-patients.aspx). Pharmacists haven't been much happier. Walgreens pharmacies in Washington turned away Medicaid prescriptions (http://union-bulletin.com/news/2010/mar/22/pharmacy-chains-decision-to-reject-medicaid/) because they were losing money filling them (the state relented) and pharmacies did the same in Delaware (http://www.duanemorris.com/news/news3338.html).
Expanding the pool of potential health care providers is a great idea. But, believe it or not, physician assistants, nurse practitioners, optometrists and pharmacists expect to be paid, too. If they get frustrated and lose money the same way physicians have, there will just be a larger pool of people refusing Medicaid patients.


http://reason.com/blog/2013/02/11/obamacare-physician-crunch-has-californi

[SassyLady]

I do and here's why; there have been calls for years to allow nurse anesthetists, midwives, etc., throughout the country, only a few states allowed. That was on the STATE level. Suddenly the tax monster decides that optometrists, dentists, etc., are going to be 'just fine' as alternatives to docs. I guess the guys at 4 eyes can take a Saturday course for credit resulting in 'caring for the common cold,' and be able to bill the government.

Great idea! it's the reason I posted the related Medicare scandals, all within the past few months.

Kath ... posted my opinion above before I read this. We are on the same page with this.

[fj1200]

Kath ... posted my opinion above before I read this. We are on the same page with this.

Your blogger disagrees.


more.......

Expanding the pool of potential health care providers is a great idea.

[red states rule]

This happens every few years and that's why the medical field is booming right now. Ten years ago, we had to pay double for contract pharmacists because there was a shortage in pharmacists-now there's too many. Technicians usually take on more during shortages, this is not an unusual story. Hopefully the increases in doctor jobs will make up for the losses in less skilled medical jobs that have been blamed on Obamacare.

What good is having an Obamacare insurance card if there is no Doctor to see and treat you? Once again, you have shown that the actual results of a liberal program is irrelevant - only the good intentions of that program

[red states rule]

Like there's no waste and corruption in the private sector?

This federal program requires everyone to buy there own insurance. This is forcing demand up in the medical fields so they are experiencing shortages. What part of this is bad for business?

As for quality, I was referring to what happens in the pharmacy business and will happen in the rest of the medical profession. Doctors will still make important decisions, but lesser tasks will be delegated down. Mistakes could happen, but it's not worth a panic.

Bing, how are people going to "buy" their insurance when people are seeing their work hours reduced or their job eliminated due to Obamacare, the CHEAPEST plan offered for a family of 4 is $20,000; and who is going to pay for the cost of Obamacare as the cost to taxpayers of this program are going to explode in the out years?

The only mistake here was libs thinking they could control the free market

[logroller]

Bing, how are people going to "buy" their insurance when people are seeing their work hours reduced or their job eliminated due to Obamacare, the CHEAPEST plan offered for a family of 4 is $20,000; and who is going to pay for the cost of Obamacare as the cost to taxpayers of this program are going to explode in the out years?

The only mistake here was libs thinking they could control the free market
It's you that's mistaken if you believe healthcare is a free market. Its been highly regulated for years. look at the OP; you're arguing in favor of strict adherence to a regulatory hierarchy. Take a step back and think for a moment on a market expanding service delivery to a greater number of providers. You're blinded by disdain if you believe that's not advantageous to the market. That may not be advantageous to the consumer; this being the fundamental reasoning for regulation. But the argument against federal mandate due to cost in the same breath as an argument against state expansion of service providers defies logic. What, exactly, do you want? Less fed, less state and less providers. Why not just ban healthcare altogether?

[Kathianne]

It's you that's mistaken if you believe healthcare is a free market. Its been highly regulated for years. look at the OP; you're arguing in favor of strict adherence to a regulatory hierarchy. Take a step back and think for a moment on a market expanding service delivery to a greater number of providers. You're blinded by disdain if you believe that's not advantageous to the market. That may not be advantageous to the consumer; this being the fundamental reasoning for regulation. But the argument against federal mandate due to cost in the same breath as an argument against state expansion of service providers defies logic. What, exactly, do you want? Less fed, less state and less providers. Why not just ban healthcare altogether?

There's a lot to be said about eliminating medical, dental, vision insurance programs. Let the market set the price, with people paying out of pocket. Major medical should be available to everyone that wishes to purchase it.

[logroller]

There's a lot to be said about eliminating medical, dental, vision insurance programs. Let the market set the price, with people paying out of pocket. Major medical should be available to everyone that wishes to purchase it.

Across the board, cash only? Meaning NO third party payers save major medical? Hmmm.

I could say a lot about that too; I love the idea of a la carte pricing. However, insurance companies are first and foremost investment houses (annuities etc). So whatever premium that is necessary to cover liabilities is a function of the market. Admittedly, as "middle man", they take their cut and this results in some additional costs; but such brokerage also streamlines market transactions, and can work to keep medical costs down. Many different insurers offering same/ different products would still offer the benefits of markets. Its just the single payer that truly worries me.

[Kathianne]

Across the board, cash only? Meaning NO third party payers save major medical? Hmmm.

I could say a lot about that too; I love the idea of a la carte pricing. However, insurance companies are first and foremost investment houses (annuities etc). So whatever premium that is necessary to cover liabilities is a function of the market. Admittedly, as "middle man", they take their cut and this results in some additional costs; but such brokerage also streamlines market transactions, and can work to keep medical costs down. Many different insurers offering same/ different products would still offer the benefits of markets. Its just the single payer that truly worries me.

Until it became 'expected' that medical insurance would cover and become part of 'benefits' of employment, medical costs were within reach of most Americans, indeed most Europeans for that matter. Then came the post WWII changes. First with Major medical, then with medical. Then dental, then vision, then for some, veterinarian. All prices were driven up.

Firstly because of ease, then because of paperwork. Indeed, we've plenty of folks still alive that will attest to going to docs that had a nurse and receptionist. Same docs, sort of same care, now have nurses and more than 8 folks dealing with 'staff.' Meaning insurance. The 'staff' employees make more than the nurses employed.

[SassyLady]

Your blogger disagrees.

Didn't say I agreed with the blogger ... agreed with Kath. The link to the site was to show what is currently being discussed.

[logroller]

Until it became 'expected' that medical insurance would cover and become part of 'benefits' of employment, medical costs were within reach of most Americans, indeed most Europeans for that matter. Then came the post WWII changes. First with Major medical, then with medical. Then dental, then vision, then for some, veterinarian. All prices were driven up.

Firstly because of ease, then because of paperwork. Indeed, we've plenty of folks still alive that will attest to going to docs that had a nurse and receptionist. Same docs, sort of same care, now have nurses and more than 8 folks dealing with 'staff.' Meaning insurance. The 'staff' employees make more than the nurses employed.
I couldn't agree more. Employers shouldn't be providing health insurance. The roots of which stem from circumvention of austerity measures. That's not to say individuals shouldn't be able to buy insurance; just that employers should compensate their employers with cash or its equivalent (stocks etc) and how the employee chooses to manage their health costs is their decision. If a doctor wants to accept cash only, or credit cards and not debit, or insurance from blue cross and not american casualty, so be it; but IF the cash market's price point still leaves tens of millions untreated, is that a problem?

[red states rule]

It's you that's mistaken if you believe healthcare is a free market. Its been highly regulated for years. look at the OP; you're arguing in favor of strict adherence to a regulatory hierarchy. Take a step back and think for a moment on a market expanding service delivery to a greater number of providers. You're blinded by disdain if you believe that's not advantageous to the market. That may not be advantageous to the consumer; this being the fundamental reasoning for regulation. But the argument against federal mandate due to cost in the same breath as an argument against state expansion of service providers defies logic. What, exactly, do you want? Less fed, less state and less providers. Why not just ban healthcare altogether?

LR - R's offered up such ideas as allowing ins companies to sell across state lines but Dems would have nothing to do with such ideas

There sole purpose was to clobber America with a massive tax bill and try to put private ins companies out of business


http://www.youtube.com/watch?v=UfOWnZ82Pm4


and here is Obama in his own words



http://www.youtube.com/watch?v=6kADU6uijvw

[red states rule]

Like there's no waste and corruption in the private sector?

This federal program requires everyone to buy there own insurance. This is forcing demand up in the medical fields so they are experiencing shortages. What part of this is bad for business?

As for quality, I was referring to what happens in the pharmacy business and will happen in the rest of the medical profession. Doctors will still make important decisions, but lesser tasks will be delegated down. Mistakes could happen, but it's not worth a panic.

Again Bing you seem to ignoring these questions.

How can people buy their own insurance if they are no longer employed or had their work hours cut to below 30 hours per week thanks to Obamacare?

and how can a family afford coverage with less income and pay for the cheapest plan that costs $20,000/yr?

How can people who do have insurance get treatment with millions more dumped into the health care system with fewer trained Doctors?

[fj1200]

Didn't say I agreed with the blogger ... agreed with Kath. The link to the site was to show what is currently being discussed.

Of course. I was just pointing the apparent dichotomy of positions that some hold. A desire for less government/deregulation but leery when they might have to actually deal with the free market and make personal decisions.

But in addition to the reimbursement issues that reason.com raised just wait for the malpractice issues to kick in.

[red states rule]

Looks like LR and Bing have left the building :laugh2:

[red states rule]

http://media.townhall.com/Townhall/Car/b/payn_c10717920130215120100.jpg

[fj1200]

Looks like LR and Bing have left the building :laugh2:

What's the point of discussing when you don't even bother discussing the point of the thread?

[red states rule]

What's the point of discussing when you don't even bother discussing the point of the thread?

Eh if you were not so anxious to take your cheap shots you go back and re-read my direct questions to your two buddies. I understand your desire to attack me and derail the thread (I guess you have adopted them since ConMan has been thrown out of the building) but I have asked direct questions to both and they remain unanswered

[fj1200]

Eh if you were not so anxious to take your cheap shots...

Cheap shots eh?


Looks like LR and Bing have left the building :laugh2:

That's rich.


... you go back and re-read my direct questions to your two buddies. I understand your desire to attack me and derail the thread (I guess you have adopted them since ConMan has been thrown out of the building) but I have asked direct questions to both and they remain unanswered

Your direct questions are not on point to deregulatory actions taken by California. Try talking about what the state is doing instead of what the Feds have done.

Attack you? Yes, you're quite the martyr. :rolleyes:

[Voted4Reagan]

Again Bing you seem to ignoring these questions.

How can people buy their own insurance if they are no longer employed or had their work hours cut to below 30 hours per week thanks to Obamacare?

and how can a family afford coverage with less income and pay for the cheapest plan that costs $20,000/yr?

How can people who do have insurance get treatment with millions more dumped into the health care system with fewer trained Doctors?

wait till they raise the minimum wage to almost $9 or $10 per hour.

those unemployment lines will grow and a lot more folks wont be able to afford the $20,000 per year plan.

It will cascade until we are just like Europe.....

[red states rule]

http://media.townhall.com/Townhall/Car/b/81_12740020130218114001.jpg