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News-Sentinel.com Your Town. Your Voice.
Opening Arguments

Tough choice

This sounds a lot like "Leth them eat cake," doesn't it?

President Obama's solicitor general, defending the national health care law on Wednesday, told a federal appeals court that Americans who didn't like the individual mandate could always avoid it by choosing to earn less money.

On the other hand, maybe this is an attempt to further the administration's goal of helping the little people. The more of us there are, the easier we will be to spot.

Comments

tim zank
Fri, 06/03/2011 - 9:29am

Sorta "dovetails" with Obama's suggestion regarding high gas prices, just trade your car in. The answers are easy, just ask him or his czars.

Harl Delos
Fri, 06/03/2011 - 12:45pm

It confuses me why the party that champions personal responsibility opposes people being made to be responsible for their own health care costs.

William Larsen
Fri, 06/03/2011 - 12:58pm

I still believe the supreme court will rule this to be unconstitutional. One of the main cost reductions put forth is to digitize medical records. A recent article I came across stated the taxpayer would fund up to $40,000 of the cost. One firm did this and found themselves close to bankruptcy. They spent $400,000, implemented and found that the increase in efficiency paid less than 1/6th of the cost. The single largest problem was communicating with other networks/doctors/hospitals/government. There is no standard.

The simple fact is as we get older, we tend to require/use/seek more healthcare (joint replacements, medications, treatments). With birth rates at zero population growth, we are no longer diluting the old age and the average age of the population is increasing => the average rate of increase in healthcare costs will be greater than ever before. In fact it will begin to accelerate.

Many in the healthcare are now getting out of the practice of treating Medicare, just as it is now difficult to find healthcare providers who accept Medicaid. What we could end up with is a country with provisions for Medicare and Medicaid, but no healthcare network willing to accept them as patients.

tim zank
Fri, 06/03/2011 - 2:09pm

"Harl Delos Says:

June 3rd, 2011 at 1:45 pm
It confuses me why the party that champions personal responsibility opposes people being made to be responsible for their own health care costs."

Any chance someone out there could translate this for me?

Harl Delos
Fri, 06/03/2011 - 2:59pm

Lancaster General was the first to move here, and initially only their employees used EPIC, but gradually, all the hospitals and all the independent doctors have decided to use it. It's like word processing software. Initially, there were a dozen choices. Now, no matter what software you buy, you can read and write MS Word file format.

In this case, EPIC is serviced from the same cloud, so everyone is sharing the same database. It used to be that half my office visits was spent updating my medical history, and doctors were always ordering tests I'd just had. Now, the history is already updated, doubling doctor's productivity, and duplicate tests are eliminated, saving those costs as well.

My old doctor always was digging for papers with old test results, but with EPIC, they can almost instantly pull info onto the same screen, for instance, showing how test results have changed over time, making outcomes better.

If Parkview and Lutheran adopt the same software, especially if it's cloud-based, it won't take long before everyone is using it - including other hospitals in Bluffton, Van Wert, Angola, etc. No arm twisting - it's simple economics.

Tim, the individual mandate is that you MUST pay your own bleeping medical bills instead of foisting them onto the rest of us. Why is being responsible for yourself such a bizarre notion?

Andrew J
Fri, 06/03/2011 - 8:04pm

personal responsibility means everyone caring for themselves and being insured for medical coverage is intrinsic to that unless u r filthy rich and will pay cash for every medical procedure or u never get seriously sick until the day u die.

gadfly
Fri, 06/03/2011 - 10:29pm

Harl:

Obama's Solicitor General did not have in mind that we must pay our own bleeping medical bills. He suggested that we should reduce our income in order not to have to pay government mandated insurance premiums.

As for common software formats, that is all fine and good, except the hospitals have these excessive documentation requirements that require nurse after nurse to interview patients about their recollection of their health history. I just experienced this phenomenon with my 89 year old aunt who suffers from dementia but still got interviewed by hoards of nurses who dutifully recorded the answers on their laptops. All this idiocy results from medical providers fearing lawsuits and higher malpractice insurance premiums.

Harl Delos
Sun, 06/05/2011 - 10:11pm

You don't have to reduce your income to escape the mandate. You can also avoid it by living in a US territory such as Guam or USVI, or by living outside the US entirely. The idea is just an update of the requirement that you get vaccinated in order to attend public schools, schooling being mandated. You need to take responsibility for your own health because if you don't get doctoring when needed, you could infect ME. The best "tort reform" is avoiding the tort in the first place.

The software I am referring to is being used by the doctors in the various family practice and specialty medical practices owned by the hospitals, as well as independently owned practices. Younger doctors are choosing to be employees of larger practices so that they can take turns having evenings and weekends free for their families, and so that they can practice medicine all the time, instead of spending so much time on business management.

When we see a new doctor, instead of spending an hour filling out a medical history, then getting interviewed by the nurse for another hour before seeing the doctor, the nurse asks if there have been any changes recently, and she enters those, and then the doctor has a nicely-typed, easily readable, extremely thorough history in front of him the first time he sees the patient.

Preventing errors and omissions by getting your doctor complete and accurate information isn't idiocy; it's extremely good medicine. What's idiocy is not taking advantage of modern technology to avoid those errors. While I was in ICU at St. Joe's hospital in the 1990s, they phoned in an order for Klonopin, a tranquilizer I used for sleeping, and the hospital pharmacy gave me Clonodine, a blood pressure medicine, instead. Not a big problem with THAT mistake, but when doctors click to prescribe, and the Rx is automatically faxed to the pharmacist, that kind of malpractice doesn't happen.

William Larsen
Tue, 06/07/2011 - 1:22am

The VA has been using digitized medical files for years. Do they help, NO!! My file is over 2000 pages and no one is going to go through the file to find out what is wrong. Teh blood labs alone are good, but going page by page to find them is tedious. Try finding all the times I have been admitted and it is near impossible.

When I was taken to Parkveiw against my instructions, did they ask the VA for my records, NO! The doctor new I was treated at the VA, but Professional Emergency Physicians had already made the decision on what the problem was before they looked at me, before I even arrived and then charged for a level 5 ER visit. A level 5 requires a comprehensive medical evaluation and testing. They did neither and screwed up. Had they simply called a procedure would not have been done that now cannot be undone.

Digitizing medical records may be a nice way to go back and find out why something happened, but I seriously doubt it will help in an emergency, there simply is not enough time to find out what past history is. The best thing to do is just take a list of your current conditions and medications with you and hope that those like Professional Emergency Physicians know how to read and are doing more than just practicing medicine.

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