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Re: The Sad State of the Modern GOP

PostPosted: Fri Apr 24, 2015 3:44 pm
by BF004
Waldo wrote:The only thing about our healthcare system that makes any sense is that you go to the hospital when something is wrong with you. They don't teach how to deal with our healthcare system in school. At your prime age for learning things like that, chances are you almost never need to use it at all. Large swaths of American society has no idea of how to deal with the problem when something was wrong with you.


Very very this. Before I became a healthcare actuary and my wife a PCP provider, I had no understanding of this. Really didn't quite get the differences between primary care, specialist, urgent care and ER and what was appropriate for each. I get it now, but did not 6-7 years ago at all. Things like this should absolutely be discussed in schools.

We are trying to help this a bit on the insurance front, keep lowering cost sharing for PCP visits and are now even changing the cost sharing for a specialist visit on whether it has PCP referral. Fairly substantially too, for exampel, $25 for a PCP visit, $50 for specialist visit with PCP referral (90% chance the PCP will be able to handle the problem) and $100 copay for a specialist visit without a PCP referral. People don't like to make two trips and I get the frustration of those who will have to make two trips, but funnelling everything through the primary lowers costs quite drastically. Also increasing ER and UC cost sharing too, but that seems to have little to no impact on patient behavior.

Re: The Sad State of the Modern GOP

PostPosted: Fri Apr 24, 2015 4:44 pm
by Waldo
BF004 wrote:Before I became a healthcare actuary and my wife a PCP provider.

Protip - You might not want it getting out that your wife is a PCP provider. :lol:

Re: The Sad State of the Modern GOP

PostPosted: Fri Apr 24, 2015 5:09 pm
by BF004
Waldo wrote:
BF004 wrote:Before I became a healthcare actuary and my wife a PCP provider.

Protip - You might not want it getting out that your wife is a PCP provider. :lol:

Yeah, she definitely gets bombarded with questions from any and everyone, but she generally likes helping,

Re: The Sad State of the Modern GOP

PostPosted: Fri Apr 24, 2015 6:23 pm
by Willink
BF004 wrote:
Waldo wrote:
BF004 wrote:Before I became a healthcare actuary and my wife a PCP provider.

Protip - You might not want it getting out that your wife is a PCP provider. :lol:

Yeah, she definitely gets bombarded with questions from any and everyone, but she generally likes helping,


:lol: :lol:

http://lmgtfy.com/?q=PCP

Re: The Sad State of the Modern GOP

PostPosted: Fri Apr 24, 2015 7:01 pm
by BF004
Primary Care Provider or Family Medicine

MD, PA or NP that specializes in general care/preventative medicine.

If you 'have' a docter, they are typically a PCP.


Not really sure why I said PCP provider above, that is like saying just for your fyi. :8)

Re: The Sad State of the Modern GOP

PostPosted: Sat Apr 25, 2015 1:20 am
by raptorman
Waldo wrote:
raptorman wrote:My prediction is this. That within 3 years every employer who does not have to provide health insurance will stop doing it. Their employees will ask them to stop so they can move over to the marketplace plans and get federal subsidies on their insurance. It only makes sense. Why pay $1,000 a month when you can pay $400 a month and let the feds pick up the rest. Having a company plan will no longer be a benefit but burden for companies with less than 50 employee's.


Well the tax portion of it will need to be sorted out though. Remember that the employer contribution is essentially untaxed income for an employee (aka a government subsidy). Ideally the move away from employer provided plans would be tax neutral.

Ignoring the $$ aspect though, few employers can match the marketplace when it comes to plans; people need and prefer different things and don't like to switch plans unless in their best interest. When it comes to employer plans, variety is low (for most employers), and insurers often change every few years at the employers whim.

I don't see them going after taxing the payment the companies make for healthcare coverage. It would have way to much of a negative effect on certain groups of people. Like union employee's and government workers. Just think of the teachers. Holy hell, the **** would hit the fan. I remember looking at WI database, they had a teacher in Superior making $14,000 a year with benefits of $25,000 a year. No way they could tax that.

Re: The Sad State of the Modern GOP

PostPosted: Sat Apr 25, 2015 6:48 pm
by GreenDay
BF004 wrote:Also increasing ER and UC cost sharing too, but that seems to have little to no impact on patient behavior.


The ER stuff is pretty easily addressed. You just have a doc there to do triage. If people come in with cold symptoms and other minor stuff (that is, non-ER), you just schedule an appointment for the next day with a primary and send them home. This works at city hospitals. But you still need that infrastructure to handle an uninsured patient population, even with OC and Medicaid expansion. And the cost doesn't matter because people know that hospitals won't turn them away for emergency care (although many private hospitals will 'transfer' you to the city/county hosp).

Re: The Sad State of the Modern GOP

PostPosted: Mon May 04, 2015 10:55 pm
by wallyuwl
An article from the Louisville paper with a survey of ER physicians saying they are getting a lot more people now than before Obamacare. It is due to the shortage of primary care physicians. Gee, it is like some people were saying this would happen, and for this very reason, but were ignored and ridiculed by the party in power. After all, they did win (Obama's famous quote) and maybe it just had to pass to see what was in it.

http://www.courier-journal.com/story/ne ... /26840437/

Re: The Sad State of the Modern GOP

PostPosted: Mon May 04, 2015 11:25 pm
by BF004
GreenDay wrote:
BF004 wrote:Also increasing ER and UC cost sharing too, but that seems to have little to no impact on patient behavior.


The ER stuff is pretty easily addressed. You just have a doc there to do triage. If people come in with cold symptoms and other minor stuff (that is, non-ER), you just schedule an appointment for the next day with a primary and send them home. This works at city hospitals. But you still need that infrastructure to handle an uninsured patient population, even with OC and Medicaid expansion. And the cost doesn't matter because people know that hospitals won't turn them away for emergency care (although many private hospitals will 'transfer' you to the city/county hosp).

Triage can absolutely be done by an RN, 4x cost savings there. :wink:

Re: The Sad State of the Modern GOP

PostPosted: Wed May 06, 2015 4:05 pm
by raptorman
BF004 wrote:Very very this. Before I became a healthcare actuary and my wife a PCP provider

Did I read that right, your wife deals in PCP? Holy crap man! :D

Re: The Sad State of the Modern GOP

PostPosted: Sun Jun 21, 2015 3:41 pm
by get louder at lambeau
Waldo wrote: They don't teach how to deal with our healthcare system in school.


They don't teach much about finance either. Probably the main way people differentiate between success and failure in life is an afterthought that is occasionally touched on in math class.

If they taught finance as a required class from, say, 7th grade thru 12th, do you think our economy, our national debt, and the American people's personal finances in aggregate, would be in anywhere near as bad a state as they currently are? Not a chance. How it is now is bad for America, but great for financial predators.

Most people, even relatively intelligent people, have no idea who creates our money or how. Most have no idea what fractional reserve banking is, or who/what the Federal Reserve Bank is, where it came from and what powers they have and don't have.

This is a major failure of education that is hurting our country badly.