Obama: Healthcare debate is "over"

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Accountable

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I don't understand when you say, 'opinion disguised as statistic'. The study I quoted is below, along with an abstract of the results of the study written by the researchers.

http://www.washingtonpost.com/wp-srv/politics/documents/american_journal_of_medicine_09.pdf
I thought my paragraph after that ststement explained what I meant. Besides, you did a pretty good job of responding for someone who doesn't understand. :)

~~~~~~~~~~~~~~~~~~~
My remarks are in blue
Originally Posted by American Journal of Medicine
RESULTS: Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. Adequate budgeting includes an emergency fund of 6-8 months income; more than adequate to cover most of these debts. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Mortgaging a home to pay medical bills makes no financial sense (unless payment must be paid up front, that is). Also, we must keep in mind that declaring bankruptcy does not mean losing the house and becoming homeless in most states (I don't know about all states' laws). Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001. None of these final statements take any mitigating circumstances into consideration, which was my original point.

I was going to save you some carpal tunnel pain from calling me heartless, etc, by explaining my philosophy of self-responsibility, but I doubt it would do any good.
 

Minor Axis

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I don't understand when you say, 'opinion disguised as statistic'. The study I quoted is below, along with an abstract of the results of the study written by the researchers.

Nova claims "reasoned arguments" but any statistic you put up he disagrees with, he's gonna verbally trash it. IT DOES boil down to whom "you" want to believe and he proves it daily.
 

nova

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Nova claims "reasoned arguments" but any statistic you put up he disagrees with, he's gonna verbally trash it. IT DOES boil down to whom "you" want to believe and he proves it daily.

Thanks for that substantive rebuttal to my positions. News flash but yelling " NO ITS NOT!!!!!!!!!" at the top of your lungs doesn't make it so.

And serious question, have you EVER, even once in your life, had to work with complex data sets?

Because the things I'm telling you are straight out of college level Stats 101. First they teach you how to do basic statistics and then they teach you how to adjust the stats so that you can get a comparison that gives you an accurate picture of the reality of what you're trying to compare.

Another direct question to you. What is your rationale for using life expectancy stats that include accidents, lifestyle differences and other factors not dependent upon the health care system, to compare effectiveness of health care systems.

I'll give this example again and hopefully this time you'll read it and understand it. Assume you have two health care systems of equal effectiveness. These systems keep sick people alive to age 100. Ignoring accidents, the life expectancy of both systems is 100 years.

Now assume everything is the same except system A has 5X as many people killed instantly in car accidents as System B, spread out evenly over all ages. Mathematically the life expectancy of System A will go down. The effectiveness of the health care systems is still exactly the same by our own scenario agreement, and yet the life expectancy of A is lower than B.

How can you use those stats to say B is better than A? The answer is you can't. If the accidents rates were both the same (the first part of the scenario with no accident rate) you could, but not with different accident rates. Normalizing the data for accident rates converts the data back to a form where you can compare the health systems because it removes the effects of accidents.

Its not a matter of what you "want" to believe, and its not a matter of stats I disagree with, its a matter of whats mathematically correct.

I'm really really perplexed as to why you're having such a hard time with such a simple concept. It feels like you're being purposefully obtuse. Like you just want to quote a 10 second sound bite and have it stand as the pinnacle of evidence without any investigation and critical evaluation.

Like the big headlines that scream "Murder Rate in Town A Doubles." Sounds horrible doesn't it. Nevermind that it just went from 1 murder to 2. From a rate of 0.001/10000 to 0.002/10000...
 
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nova

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Yep, the Census Bureau does say that. You can't really draw any useful conclusions from that though.

You have to ask the 100% legit question "Why are those people uninsured?" Until you quantify the answer to that question you don't know whether they just can't afford it (a big problem) or they just don't want it (not really a problem) or anything in between.

Well it just so happens both the Census Bureau and the CBO did ask that question and the answer they came up with is encapsulated in the cartoon below. There are approx 8-10 million chronically poor and uninsured in this country.

That is a problem that needs to be addressed. However it is not a tear down the system and start over problems or a gov't takeover of health care problem. Its a problem of Medicaid reform. A reform effort that I would be behind and I'd bet $$ you could get 99% of the rest of the American public behind.

In other words if the politicians would address the real problem instead of trying for a power grab, we could have had this reform done months ago...

toon072409.gif
 

retro

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Honestly not all that surprising to me; as I've noted previously, doctors are already considering dropping Medicare from their practices completely. Cardiologists and Oncologists are closing their practices because of massive Medicare cuts to their reimbursements. But despite the fact that I've brought this up, none of our find ObamaCare supporters around here seem to give a rats ass about that part of it.
 

nova

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I know I've stated this to you before ret, but depending on how things shake out, my wife and I are looking at her only working 3-4 days a week after residency and she's gonna be family practice. Depending on specifics it may not make any economic sense for her to work more than that....
 

retro

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I know I've stated this to you before ret, but depending on how things shake out, my wife and I are looking at her only working 3-4 days a week after residency and she's gonna be family practice. Depending on specifics it may not make any economic sense for her to work more than that....

Good luck with that, because while it might make financial sense for you guys, if she's wanting to work for a group, it might not make financial sense for them, as she's going to need to be able to cover her overhead for it to be worth it for her. If you ever want to move to the hell hole of California, I know my dad is always recruiting FP docs ;) :24:
 

Tim

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You've got to be shitting me with this article. Take a little of your own advice and go read the actual questions that were mailed out to these 1,376 respondents.

Then go look at the much larger poll done by Mount Sinai School of Medicine in New York where the majority of doctors support a public option. Oh, and read those questions as well. You can definitely see a bias in the different questions and how they are presented.

And even if your article were true, that's good for the market, right? Because when a hole is made somewhere, it is always filled by something else. That's the motto of the free market, isn't it? It will open up opportunities for all those aspiring men and women that want to be doctors.
 

retro

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You've got to be shitting me with this article. Take a little of your own advice and go read the actual questions that were mailed out to these 1,376 respondents.

Then go look at the much larger poll done by Mount Sinai School of Medicine in New York where the majority of doctors support a public option. Oh, and read those questions as well. You can definitely see a bias in the different questions and how they are presented.

And even if your article were true, that's good for the market, right? Because when a hole is made somewhere, it is always filled by something else. That's the motto of the free market, isn't it? It will open up opportunities for all those aspiring men and women that want to be doctors.

I know for a fact that most doctors in the central valley of California oppose a public option because of Medicare, yet the survey claims that doctors prefer Medicare to private insurance for patient care. I also know a good number of doctors that support Obama are opposed to a public option as well. For the main reason that, as written, the House bill would eventually eliminate private insurance and force everyone onto the public plan. But hell, when Medicare is already forcing doctors to close their practices because reimbursements are being cut even further, it's insane to actually think that doctors prefer Medicare. Part of the same survey shows that doctors support an expansion of Medicare so that it will better cover elderly patients, and extend that coverage to those 55-64 as well.

Doctors seem to be very much in favor of health care reform that includes: tort reform, Medicare reform, prescription drug reform. I don't think you'll find a single physician that thinks the health care system if perfect and doesn't need any changes. But I also think you'll find that most physicians are opposed to a single payer plan.

Furthermore, asking doctors if they support a public healthcare option is a very nebulous question because we already have public options in place in the forms of Medicare and Medical. So if you asked a doctor if they support any public health care plan, chances are they're going to say that they want a mix of private and public plans available, since they're already dealing with public plans in the form of Medicare, and while they might not like them, they know they're not going away either. They weren't asked anything specifically, like if they supported the public option as is being presented by congress currently, only if they supported a public option, which would imply of any type. Only 10% of doctors surveyed actually said that they only want a public option, that should be telling as well.
 

nova

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You've got to be shitting me with this article. Take a little of your own advice and go read the actual questions that were mailed out to these 1,376 respondents.

I did, thanks much. I see no problem with the questions. They are not leading questions in the realm of "Do you support of oppose the communist health care plan that will kill babies and old people?"

On top of that, being married to a Doc, I've got a bit of anecdotal evidence to go along with said survey. I've personally heard, with my own two little ears, no less than a dozen older docs say they they only work to keep from being bored and that they will quit and go home before they put up with any more shit outta the gov't.

Now, since you're calling people out, will you show me the law requiring management of a business to gut the long term viability of a company for short term profits, Mr Big Expert Businessman?

http://www.offtopicz.net/50245-obama-speech-kiddies-9.html#post1255224

Then go look at the much larger poll done by Mount Sinai School of Medicine in New York where the majority of doctors support a public option.

ROFL, "much larger" poll? You mean this one that sampled around 2000 docs instead of around 1400.

http://www.rwjf.org/files/research/48408physician.pdf

Look at what those docs are being asked at the top level...


Respondents were asked to indicate which of three options they would most strongly support:
[FONT=AGaramond,AGaramond][FONT=AGaramond,AGaramond]1. Public and Private Options: [/FONT][/FONT]Provide people under age 65 the choice of enrolling in a new public health insurance plan (like Medicare) or in private plans.
[FONT=AGaramond,AGaramond][FONT=AGaramond,AGaramond]2. Private Options Only: [/FONT][/FONT]Provide people with tax credits or low income subsidies to buy private insurance coverage (without creating a public plan option).
[FONT=AGaramond,AGaramond][FONT=AGaramond,AGaramond]3. Public Option Only: [/FONT][/FONT]Eliminate private insurance and cover everyone in a single public plan like Medicare.

then look further down in it...


Support for Expanding Medicare Coverage
[FONT=AGaramond,AGaramond][FONT=AGaramond,AGaramond]Overall 58.3% of physicians support Medicare expansions to individuals 55 to 64 years of age (Figure 2). This support was consistent across all four specialty groups and ranged from (55.6% to 62.4%, p=0.08) across specialties
[/FONT]
[/FONT]

So 63% want a mixed system letting people under 65 buy into a "public plan like Medicare" and 58% want to let people age 55-64 buy into Medicare.

Don't you think there might be a bit of overlap in there? Maybe, just maybe since the first question is inclusive of the second?

Not to mention the fact that the surveys give two totally different pieces of information.

The Sinai survey indicates that Drs. think we need reform, which we do in several areas, not the least of which is Medicaid, but it does not indicate exactly what the reform plan should be, only that they prefer a mixed "public private system" which could mean almost anything. It could mean the plan that I've posted multiple times.

The IBD survey indicates that Drs. do not like the reform packages as they are currently constituted.

Two different surveys, two relevent pieces of information applicable to different areas.

Oh, and read those questions as well. You can definitely see a bias in the different questions and how they are presented.

Oh yes most definitely biased. For sure :sarcasm
Do you support of oppose the current health care plan?
Will you quit or keep working if the health care plan passes?
Do you believe care can be provided to 47 million more people and have it cost less and provide a better quality of care?

Please explain where you see bias in those questions?

Or would you prefer questions to the effect of "Do you support or strongly support the current health care plan?"

And even if your article were true, that's good for the market, right? Because when a hole is made somewhere, it is always filled by something else.

That's the motto of the free market, isn't it? It will open up opportunities for all those aspiring men and women that want to be doctors.

Except for a few bits and pieces you're missing in your economic brilliance, yes.

1. Training and licensing requirements mean that any "surge" in doctors is at least a decade out. The shortest education and training cycle is for family docs like my wife. It lasts 11 years minimum. Cycles for specialists can last nearly 20 years.

2. If the gov't is cramming down the amount Drs. make by cramming down payment for services, which is the only way to cut costs, if like the proponents claim you can get whatever care you want whenever you want it, then there's not a whole lof of incentive to spend a decade or two and north of $150,000 to go through med school now is there?

There's already a shortage of PCPs and family docs, WTF exactly do you think is gonna happen if you drive down the number of people becoming Drs as the population continues to grow.
 

Dakota Jim

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I did, thanks much. I see no problem with the questions. They are not leading questions in the realm of "Do you support of oppose the communist health care plan that will kill babies and old people?"

On top of that, being married to a Doc, I've got a bit of anecdotal evidence to go along with said survey. I've personally heard, with my own two little ears, no less than a dozen older docs say they they only work to keep from being bored and that they will quit and go home before they put up with any more shit outta the gov't.

Now, since you're calling people out, will you show me the law requiring management of a business to gut the long term viability of a company for short term profits, Mr Big Expert Businessman?

http://www.offtopicz.net/50245-obama-speech-kiddies-9.html#post1255224



ROFL, "much larger" poll? You mean this one that sampled around 2000 docs instead of around 1400.

http://www.rwjf.org/files/research/48408physician.pdf

Look at what those docs are being asked at the top level...



then look further down in it...



So 63% want a mixed system letting people under 65 buy into a "public plan like Medicare" and 58% want to let people age 55-64 buy into Medicare.

Don't you think there might be a bit of overlap in there? Maybe, just maybe since the first question is inclusive of the second?

Not to mention the fact that the surveys give two totally different pieces of information.

The Sinai survey indicates that Drs. think we need reform, which we do in several areas, not the least of which is Medicaid, but it does not indicate exactly what the reform plan should be, only that they prefer a mixed "public private system" which could mean almost anything. It could mean the plan that I've posted multiple times.

The IBD survey indicates that Drs. do not like the reform packages as they are currently constituted.

Two different surveys, two relevent pieces of information applicable to different areas.



Oh yes most definitely biased. For sure :sarcasm


Please explain where you see bias in those questions?

Or would you prefer questions to the effect of "Do you support or strongly support the current health care plan?"



Except for a few bits and pieces you're missing in your economic brilliance, yes.

1. Training and licensing requirements mean that any "surge" in doctors is at least a decade out. The shortest education and training cycle is for family docs like my wife. It lasts 11 years minimum. Cycles for specialists can last nearly 20 years.

2. If the gov't is cramming down the amount Drs. make by cramming down payment for services, which is the only way to cut costs, if like the proponents claim you can get whatever care you want whenever you want it, then there's not a whole lof of incentive to spend a decade or two and north of $150,000 to go through med school now is there?

There's already a shortage of PCPs and family docs, WTF exactly do you think is gonna happen if you drive down the number of people becoming Drs as the population continues to grow.


For a NOOB posting with Tim, an administrator and longtime member, you sure have a shit attitude. Stick to your argument and lose the smart ass name calling.
 

Dakota Jim

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I know I've stated this to you before ret, but depending on how things shake out, my wife and I are looking at her only working 3-4 days a week after residency and she's gonna be family practice. Depending on specifics it may not make any economic sense for her to work more than that....


Exactly what's wrong with today's medicine. Instead of physicians entering the field for desire to help cure and mend, they are in it for $$$$$$$$$$. Fuck all new mercenary doctors.
 

Alien Allen

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Yeah people spend all that money to go to med school and do the intern shifts should never be wealthy. Lets dumb down the whole system and just make it a trade school degree. That is about what the care will be worth under this garbage plan
 

nova

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For a NOOB posting with Tim, an administrator and longtime member, you sure have a shit attitude. Stick to your argument and lose the smart ass name calling.

I'm just reflecting his own opinion of himself my man....

http://www.offtopicz.net/50446-who-rushing-home-listen-president-obama-4.html#post1256786

Let me fill you in on something son. I have been involved with business since before you were a twinkle in you fathers eye. I have personally paid more dollars into the worker's comp fund than you have seen in your lifetime. I acquire more dollars in contracts yearly and manage those projects than you will make in your lifetime. So don't tell me about worker's comp and what it does. It's an insurance on top of another insurance. It ensures that liability of a company is covered in the event that a worker is injured on the job. It pays for all medical coverage and any future medical costs attributed to any workplace accident. It also covers any possible lawsuits and loss of future earnings. The latter two would still need coverage, but at a reduced rate of the current system since the vast majority of claims require only medical coverages. And why would you need to make sure medical coverages are available to employees if EVERYONE is already covered?

If me calling back when he calls me out is grounds for a warning, ban or other discipline, somehow as an admin I think he can handle it himself so thanks but no thanks for your input....

Exactly what's wrong with today's medicine. Instead of physicians entering the field for desire to help cure and mend, they are in it for $$$$$$$$$$. Fuck all new mercenary doctors.

Yes, fuck my loving wife for expecting compensation for the 5 years she spent in undergraduate education, the 4 years in medical school and the 3 years she'll spend in residency working 80 hours a week with 30 hour shifts every 4th day for what amounts to $8/hour. Fuck her for expecting enough compensation to pay back $150,000 in student loans, $60,000-$80,000 a year in medical malpractice, and god only knows how much for nurses, office staff and other overhead and still live a decent life. Fuck that greedy bitch! She should work for next to nothing just because near slavery is cool :sarcasm

Now that we're done deciding what is adequate compensation for someone else's job. Can we decide what yours is next?

I swear I never cease to be amazed at the ignorance of the public at large...
 
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retro

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Exactly what's wrong with today's medicine. Instead of physicians entering the field for desire to help cure and mend, they are in it for $$$$$$$$$$. Fuck all new mercenary doctors.

Do you have any freaking clue how much medical school costs? As of 2008, the average debt carried by a medical school graduate upon starting their residency is $154,607. They're not in it for the money, but they deserve to be compensated fairly, and they have massive student loans by the time they're able to enter private practice, which for a primary care physician is about 11 years after starting college, as they have college, medical school, and residency. They have to have some way to be able to pay off those massive amount of student loans and still be able to provide for their families. My dad didn't have all of his loans paid off until he was in his early 40s, and he had medical school paid for him by the Air Force in exchange for 4 years of service.

Oh, but you won't be able to read any of this because you have me on ignore, but whatever... at least other people will be able to see how ludicrous your assertion that doctors are in it for the money is. :rolleyes:

Source - AMA - Medical Student Debt
 
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Alien Allen

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Do you have any freaking clue how much medical school costs? As of 2008, the average debt carried by a medical school graduate upon starting their residency is $154,607. They're not in it for the money, but they deserve to be compensated fairly, and they have massive student loans by the time they're able to enter private practice, which for a primary care physician is about 11 years after starting college, as they have college, medical school, and residency. They have to have some way to be able to pay off those massive amount of student loans and still be able to provide for their families. My dad didn't have all of his loans paid off until he was in his early 40s, and he had medical school paid for him by the Air Force in exchange for 4 years of service.

Oh, but you won't be able to read any of this because you have me on ignore, but whatever... at least other people will be able to see how ludicrous your assertion that doctors are in it for the money is. :rolleyes:
Ignore :eek

Only pussies use ignore :24:
 

Minor Axis

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Senator Max Baucus Unveils his Health Program with no "public option" and Republican leaders blast it as too expensive.

I am convinced there is no bipartisanship and no hope for bipartisanship support for a health care bill, mostly because the Republican leadership wants no health care solution that is viewed as a success for the President. This is putting politics ahead of the good of the country and average citizens.
 

nova

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Under the bill, nearly everyone would be required to get insurance or pay a penalty

Back door tax and subsidy and handout to the insurance companies all rolled into one. Gotta love that one. So much for no middle class tax increases...

And if anybody wants to argue the tax/subsidy part, what else do you call being required by law to pay money into something you don't want in order to lower the cost for someone else?

But insurers, in turn, would not be able to deny coverage to people with preexisting medical conditions or to cancel policies after people got sick, as happens in the current system.

Hold up a minute. I thought part of the problem was the exploding cost of insurance? Those two things will drive UP the cost ;)

To help pay for his bill, Baucus is proposing a series of new excise tax on insurance plans worth more than $8,000 for singles and $21,000 for families, and new fees on insurers, drug makers, device makers and clinical labs.

Honest about the first tax at least. Still more middle class tax increases though. Article would be more accurate if it said

To help pay for his bill, Baucus is proposing a series of new excise tax on insurance plans worth more than $8,000 for singles and $21,000 for families, and new fees on consumers, consumers, consumers and consumers.

Because we all know thats who the fees will get passed on to. Also another thing that will drive up cost as well...

This thing is dead in the water unless they do straight party line in which case the Democrats are dead in the water come next fall and this plan won't be far behind.

And before anybody knocks me for focusing on cost, remember from the get go we've been fed the lie that we could expand coverage, have better coverage, and have it all cost the same or less so we could get by with no middle class tax increases.
 
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