[Chris Vais]

Normally I don't pay attention to the tabloid news, but the New York Daily News hit the ball out of the park this morning with the headline "House of Turds" a takeoff of the popular TV series House of Cards with Kevin Spacey in the least role.

The Daily News used the same opening image from House of Cards with John Boehner on the throne where Kevin Spacey would normally sit. "House of Turds" pretty much says it all. BTW House of Cards is worth a look.

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[flash]

it's a perfect example of how to show that a republic (which is what we are) is not the same as a democracy. the people elected a president TWICE on the platform of the affordable health care act, and not the guy who campaigned on the platform of overturning it. now, like a bunch of little children, the republicans are holding the country and the government hostage until they get their way. it doesn't matter that 38 million people are without health care. it doesn't matter that the public supports the plan, admittedly even though it isn't perfect, and they would like to see some things different. this has been the way of things for a while now. the elected officials are not doing what their constituency wants.



this is why we need a "none of the above" choice in all elections. it "none of the above" wins, then the other candidates are out, and a new election with new candidates is run.



we also need a balanced budget amendment. i can't believe we don't have that, and allow this nonsense to continue.

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[kzem1]

Two Words. Term Limits!

Agree on Balanced Budget Amendment

I also support the Fair Tax. Everyone should pay something and it will rid us of a majority of the IRS and the ability of politicians to use the tax code to pay back donors at the expense of the American people.



Just my 2 cents.

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[Inkedupfatboy]

Sorry, I am an American person and am NOT in favor of the affordable health care act. Sorry, 10,000 plus pages?! ridiculous.

I DIDN'T vote for this jerk TWICE! But I am stuck with him - bollocks!

The whole bloody lot of them, Obama, Clinton, Pelosi, Holder and many more are corrupt as one can be.

Sorry just my two cents worth

If you are an Obama supporter - we better change the subject now

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[Chris Vais]

I am a Obama supporter and I support the Affordable Health Care Act and I'll tell you why. My son is a recovering addict who has had no access to the health care necessary to support his sobriety until today. Like nearly 35 million other people in this country he will be able to enjoy the benefits of good health care. When I l lost my job in 2012, we went on COBRA at a cost of $2400/month. Later that year I went on Medicare and my wife continued on COBRA until this summer. When she went out to look for insurance, as an individual, she was denied, because she has a pre-existing condition, an inter cranial tumor that at some point will require a seriously expensive medical procedure for her to continue to live a productive and healthy life. Not sure what the number of pages has to do with anything, it is actually pretty easy to figure out. The bottom line is that two members of my family get affordable health insurance that up until today they would have been denied and at a cost I can afford, nothing wrong with that in my book.



I do not think that the Congress of the United States has been of service to the american people. That said, I am also tired of listening to the unfounded, undocumented, unprovable, and untrue accusations leveled at people in public office.



+1 on the Balanced budget amendment

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[flash]

corrupt is an unfounded accusation. if anybody is corrupt it has been the republican party. it is painfully clear that corporate interests have been mucking things up for far too long. the fact that they got the campaign donations legalized and hidden is outrageous. corporations should not be able to contribute to campaigns. it makes me nuts when base their opinions on fox news and "rash lamebrain" and not facts.



we must have health care for everyone. that is just common sense. we have to have a healthy labor force. without them, nothing else matters.



no matter. california is the 8th largest economy in the world, behind only the US, china, japan, germany, france, the UK and brail, and in a virtual tie with russia. there are over 40 million people here. that is going to go a long way toward determining the direction of progress. we are now on our way to a single payer system, as it should be. we will drag the rest of the country kicking and screaming into the future, and leave the selfish money grubbing ideals in the past.



the good news is that what the republicans have done is going to cost them a lot of votes. every one of those people who are affected by the shutdown will vote against them. it doesn't matter how messy or convoluted the law is. it's better than what we had. it can be tweaked later. in the meantime, people are not going to forget who shut things down with their childish temper tantrums.



and no, i'm not an obama fan, nor do i like everything the dems have done. but he's a heck of a lot better than romney, and he's here for another 3 years. they need to suck it up, take their lumps, and figure out how to work with him, and not just against him.

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[Collimare]

Vote all incumbents out!!

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I don't care, you can replace a Democrat with a Democrat, a Republican with a Republican, just vote them all out. If we do this for a couple of election cycles things will change, until then it will only get worse, much worse!! Balance the budget (yes it will be painful) and stop the obscene borrowing to run our government. Flat tax and ditch the IRS. I understand the need for affordable health care but ramming an overly complicated, all encompassing, underfunded plan down our throats was not the way to get it done. It should have been a collective/bipartisan effort by cooler heads (replace the incumbents) done in a controlled roll out with measured and corrected steps. I guarantee you that everyone (those with any money left) will be paying a heck of a lot more for health care within the next three years and the government will be in such a hole that it will make our current situation look minor in comparison. It is simple math. The few cannot support the many! Let’s be brutally honest this was about votes, LEGACY and power. “OBAMACARE” is something no former president has ever been able to do. Even if it ultimately succeeds or fails horribly it will still resonate the man’s name for years to come.

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I am a small medical manufacture and I can tell you pointedly that the government has been driving me to the brink of bankruptcy and the new Medical Device Tax (2.3% of gross) to help fund the Affordable Health Care Act may just be the last straw, but it is just the tip of the iceberg for what is in store for us all, especially those who work 60+ hours a week to build something bootstrapped with our own sweat, blood and tears.



Vote all incumbents out!!

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Wow, I feel a bit better now. Sorry if my rant offended anyone.

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[Langley968]

Us Canadians watch what is going on south of the border and come to the realization that we do not have a lot to complain about...

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[Rap]

Chris pm about your son. This is not a democrat or republican issue. The issue is about the failure of Congress to participate and perform the job they were elected to do. Term limits and a balanced budget are just a start. We at Clearbrook are stymied in our ability to plan for the future because of the lack of info about the upcoming obamacare. I suspect other business's are also. Our industry is undergoing some drastic changes that will alter our landscape. We are just a small slice of the health care delivery field. There will be a movement to dumb down reimbursement rates as we move forward. No matter what section of healthcare you talk about, this will be hugely disruptive in the delivery of care and to the providers. Jobs will be lost and companies will either go out of business or drastically change. That said, as a businessman this change will provide opportunity. The trick will be to ferret it out and make take advantage of it in a timely and cost effective manner. A grad school buddy of mine who is high up in Blue Cross told me that the policies they will offer on the public and private exchanges will lose a lot of money for three years at least! This is a chilling statement. How long will a major insurer tolerate this?

Watch as employers move their employee's into either the public or private exchanges. Our fine under obamacare would be less than one months premium. When these costs and financial responsibilities are passed onto employee's, does anyone who has a modicum of intelligence really believe that this realignment of spending will not affect our economy. All those dollars going to premiums won't go elsewhere. Even if you qualify for federal subsidies there will be a huge realignment in how people are forced to spend their money.



This country is too wealthy for everyone to not have some sort of health insurance. Medicaid would have been a better vehicle to support this venture. It already existed and provided care for people.



But as Flash said, the people voted for this. Yet under our system laws can be changed and modified. This is what The duty of Congress is. Unfortunately the only bill Congress seems able to get passed is to exempt itself from the healthcare mandate. This alone should convince people that Congress no longer represents anyone but themselves. Of course if we were a Muslim nation we would all be exempt from this mandate! Anyone who thinks the Federal gov't does a good job of looking after people only has to ask a veteran how well they are taken care of. If you want a more historical answer to that question, ask a Native American how well the Federal govt takes care of them?

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[flash]

i'm not for a second saying that obamacare is perfect. it's a mess. but it's better than the alternative, which we know was not working. the insurance companies are a large part of the problem. allowing them to exist at all creates a conflict of interest. the uninsured need care, but the insurance companies were actually encouraged to deny care. in a single payer system, that would no longer be a problem. the red tape and administration costs would plummet. sure, a lot of people in that industry would be out of work. so what? they can find new jobs. it's a lot worse to lose our work force due to poor health.



this is something that will affect generations to come. we cannot focus only on the effects on today. we have to focus on the effects of tomorrow.



congress needs to change the way they work. i agree that term limits and a balanced budget amendment are needed. that's a good start. "none of the above" would also fix a lot of the problems. eliminating campaign contributions altogether, and giving television time for free to candidates, would also take the money out of the game. the government owns the airwaves. why don't they take some of it back? why don't we level the playing field, provide the funds for campaigns, and immediately eliminate all of the nonsense?



we let this happen. only we can change it. we all get the government we deserve.

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[Inkedupfatboy]

The hoops that this so called healthcare act that the physicians are being forced to jump through, just to get paid a reasonable amount are pure crap. A big part of this is the forced implementation of electronic medical records. Yes the gov't wants to be able to access everyone's health stats. That alone is scary, but if the doctor's don't put in an EMR, they can't accept medicare and medicaid patients. So...many physicians are just saying, "You know what, I only have a few years to retirement, so I am not doing it." or, "I will just go to a cash fee system."



Long term, this health care act will cause a shortage of doctors. - I also think it will change the way doctors practice medicine as they now have to lug a lap top around and spend much more time doing data entry not patient care. Again, causing some physician's to rethink their career. The data entry that medicare asks for is far below the quality level of care that some doctor's now provide...Hmmm...I would rather rely on my doctor's and experience than a set of check boxes on a computer screen



Socialized medicine is not the answer. I know people who have died in other countries waiting for a cat scan or mri. You are going form a system that tests for everything to one that will prioritize and triage everything. "Mr. Smith, I see you need a heart cath, well, you fall outside the age limits for the affordable health care system, so if you want it, it is $100,000 and we can get that scheduled for you in say 8 months. Can't afford that? Sorry, good luck then.



Want to lower heath care costs and make it affordable, get rid of the lawyers.



Ever see the commercials? Have you taken, blank drug and suffered a side effect or death? Wonder what is going on?

The FDA constantly test drugs. When new side effect get added to a drug's warning label, the lawyers get to fishing. They put out adds and commercials asking if you have suffered this side effect....then if they get enough desperate people, they start a class action lawsuit against the pharmaceutical company, or the doctors or the procedure, (it all works the same) then the company pays a settlement to avoid a trial and the lawyers get 40% and the victims get whatever is left split between them. Yea, fair. So the drug companies and hospitals have to raise their rates to cover legal suits trumped up by lawyers.



We never used to send out kids to the ER for a complete set of x-rays and an MRI of their head when they fell out of the tree. If they came home hurt, we took them to set a broken bone, if not we smacked them on the head and said, don't fall out of the tree dumbass. and that was the end of it. If grandma was sick, we didn't put her through a complete bank of tests that costs thousands of dollars! Know why doctors do that? Because they are afraid of getting sued!!!! So they send granny off for every test possible.



We didn't keep granny on feeding tubes, iv's physical therapy and life support - 75% of all medicare and medicaid dollars are spent on the last 5 years of life over 80! Wonder why health care costs are going up - because insurance companies know this and they have to charge now so they can pay you later - people used to take care of granny at home, and when she died, she died! People die, get over it.



Also, when you used to go into the hospital you stayed there until you got fixed, then went home. Now it is hurry up and get the hell out. Oops, you got readmitted within 30 days, so guess what, the hospital and doctor don't get paid now. Hmm..yes, this act now makes it mandatory, that after you are discharged the doctor has to follow you up within so many days or they don't get paid. Then, they have to bill medicare and medicaid on the exact 29th day following a discharge or guess what, yup they don't get paid. - nice.



Thanks again to the bean counters and the lawyers.



So no, I am not a fan of the new health care act....It in my opinion is a bloated system that will not work in it's present form.



As far as my statement about the Government being corrupt, read serious reports about the fast and the furious gun scandal in Arizona - questions still have not been answered. These people could tell me the sky was blue and I would go look before I believed them.



What ever - believe what you want - it's a free country. For now.

Oh, by the way - they shut down the gov't they shut down most of the gov't websites too -

I got this today







Due to the Federal government shutdown, usgs.gov and most associated web sites are unavailable.

Only web sites necessary to protect lives and property will be maintained.

• Ecosystems
  
  • Disease Maps
    
    
• Natural Hazards
  
  • USGS earthquake information
    
    
  • USGS volcano information
    
    
  • USGS coastal erosion hazards information
    
    
  • USGS landslide information
    
    
  • USGS information on geomagnetic activity
    
    
• Water
  
  

Please see doi.gov for more shutdown information.





- Nice - they can shut anything down at any time they want - any opinion they don't like in the future, they can shut it down.

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[flash]

your assumptions are based on pure speculation.



the need for an EMR system is a given. nobody i know of uses paper anymore. everything is on computers. it's far more efficient, and far less costly to maintain. conspiracy theory nonsense aside, it's just the right thing to do. i hate computers, and i suck at transferring things over from paper, but even i have to admit that it is better, faster, and cheaper.



in no way will there be a shortage of doctors. in fact, we stand to have a surplus as a result. by eliminating much of the paperwork, and streamlining the system, medical malpractice will be reduced, and more doctors will actually be able to make a living.



the FDA may test drugs, but they don't do it enough, and the pharmaceutical industry has been let run amuck lately. they release drugs without enough testing, and then after the fact announce side effects, which are often worse than the original condition. the list of side effects in the commercials stuns me. yet people still take them, and then complain later. the companies have determined though that it is cheaper to pay some claims, than to do the testing. they are satisfied with just treating symptoms, and not actually curing anything. this feeds the medical machine, as now there are far more things to have to treat. again, the insurance industry gets involved though, as they refuse to pay claims on many of these "treatments", further burdening the public with the expense, and forcing them to seek relief in court, further burdening the public with that cost. it's all about the balance sheet. if we had a single payer system, the motivation for profit would largely go away, and while it may slow the progress of development, it would vastly improve the aggregate health, and dramatically reduce the cost of the system.



it is a well proven fact that the majority of people heal faster when not in the hospital. out patient care is a far more effective tool than long and expensive hospital stays. of course there are exceptions, but the numbers are easy to find.



i don't think you, like most people, know much about the health care act, the real fall down points of the system now, or what the realities are. obama has done a piss poor job of getting that information out there. it has resulted in people making sweeping assumptions that just are not true. it isn't hard to find the truth though.



basic medical care should not be a "for profit" business. it should be a public service. certainly i feel there should be availability of care beyond that, which could be profit based, but basic care should be a "given". it is absolutely short sighted and ridiculous to think that we can maintain a healthy work force without providing that, and without that work force, every one of us will suffer. the next time you go to your local grocery store, fast food joint, think about the health care that guy making your burger is getting, or the kid at home depot, or the guy who pumps your gas. if you think they take precautions against spreading disease, you're woefully misinformed. if you think that they are taken care of when they get hurt, you would again be wrong. they continue to go to work sick or hurt. if they don't, they get fired and go on unemployment, which comes out of your pocket too.



as an example of how effective the act is, right now, under the new act, a family of 4 with a household income of $50k (which is the group that needs it the most), can get health care for $178 a month. previously it would have cost more than 5 times that. that's a large part of the 38 million people that need it. the demand is so high that it overwhelmed the web site. this is what the majority wants. the minority will just have to learn to live with it.



by the way, it is NOT a free country. that's the same kind of misconception as thinking that it is a democracy.

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[Inkedupfatboy]

Whatever - I'm out.

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[Rap]

They may pay 178 a month but that doesn't include deductibles and out of pockets. This is where people will blanch! We implemented EMR's at the one facility to stay ahead of the curve. We still use a ton of paper and from a business perspective it doesn't provide efficiencies that help defray the expense. We have efficiencies but this system provides us with no way to recover costs. Regulations continue to add requirements that apart from being silly also don't include increases in reimbursement rates to cover the cost of meeting the new reg. This acts to decrease the actual reimbursement. Flash perhaps it is different out there buthere on the east coat I know tons of physicians in all specialties who still use paper. Just like I know these same folks who still keep paper after installing EMR systems. Having one payor is just a more efficient means of rationing care! We currently have a system that rations care in both the public and commercial insurance payor sectors. I have developed the Utilization Review units that secure authorizations for both systems. They are alike in the amount of care they authorize. It is a rigged game that can change day to day hour to hour based not on information presented but rather on other factors. We have had an ex managed care case manager who presided over UR visit us and tell us that at certain times of the month managers will go to case managers and tell them they have reached their allotment and to stop certing care. This was based not on medical necessity but from a financial perspective. One payor class will produce less care.



Reforming health care is not about reducing costs. It is about aligning effective treatment, follow up and prevention. Less does not make people healthy. Our health care is the only part of our country that has not truly been brought up to date with IT. The VA system has a system which aligns info. They may not deliver care well but their info system is good. You can't have a multiplicity of software systems that don't interact and expect to deliver quality health care at reasonable prices

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[flash]

deductibles and max out of pockets total $10,400 at that bracket. far less than even the simplest of surgeries without insurance. it does what it is supposed to do.



i can imagine that the east coast is still stuck in the 50s and working on paper. the reluctance to embrace the modern is a problem in almost every industry. you can't use both paper and digital and expect to be good at either. you have to leave behind the old and use only the new for it to work. as i said, i am also slow to make the change.



reforming health care is really all about controlling cost. the system needs to tell the providers what to charge, not the other way around. but again, it needs to be profitless in nature to work. we will never have a good system as long as basic health care is left to companies who want to make money. it is far too easy to take advantage of the system.



we have no care for 38 million people. that absolutely cannot continue. i see plenty of people complaining about obamacare, but i sure don't see them offering any alternatives that would provide for them. it's easy to sit in the cheap seats and gripe. if they haven't got a productive suggestion, they need to shut the hell up and let those who are trying to make things better get on with doing it.



keep in mind, that i have insurance, and am one of the ones who will be paying the most for both that, and subsidizing the affordable health care act. i have nothing to gain by supporting it, other than the knowledge that in doing so, i am improving the health of the nation, and thereby helping the economy, which in turn helps me.

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[biosurfer1]

Bad, bad move to allow politics or religion in the forums. Nothing good ever comes from it and all it does is risk valued members of the 968 community leaving. There is a reason so many of the forums I read have banned them and I think it's a damn good thing. Good luck with this <img src="/forum/images/smilies/968/glare.gif" class="smilie" alt="" />

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[Inkedupfatboy]

Argh I said I was out --



Well when I have to see my wife come home crying because her hands hurt so badly from typing into the EMR - I don't like it. She is having to go from being a physician to data entry and it sucks.



She used to be able to dictate a simple note into the system, have the stenographer type it out and mail it to the patient the next day. Guess what. EMR don't work that way now....now it takes days.



How many of your 38 million people are sitting on their collective asses doing nothing! IF everyone got off their lazy ass and got to work and IF we started to make quality goods in this country again and IF everyone paid a fair amount for those goods more jobs would be made and IF we stopped wanting to buy everything at wal-mart and Dollar General - then, maybe then, employers could go back to providing good salaries and benefits and our economy would turn around.



But no, every one has to have everything as cheap as possible which is why I can't buy anything that lasts more than 3 uses. And...if they don't want it cheap they want it handed to them outright with some sort of bizarre sense of entitlement - doesn't anyone want to work anymore?



I am still firm on the opinion that we need to do away with the litigation....almost 30 years ago my wife's malpractice insurance was $2500. Know what it was when we left PA? $25,000.00!!



The system is broken and not even his precious obamacare will fix it.

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[Inkedupfatboy]

Yea, Bio, you're right -



I am just sitting here totally irritated when i knew I should have stayed out of it..

By the way - thanks to our new "AFFORDABLE" system a co-pay for my last pet scan was $250...know what it is now? $950....it is not cheaper - it is like everything else the middle class pays for everyone else that expects it for free.



When you rob Peter to pay Paul, you will always have the support of Paul



Now I'm done

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[flash]

biosurfer - while i would normally agree, and we discussed this at length before adding it, actually, we have done extremely well as a group. we've had many many political discussions, and they have been some of the best ones we've had. those who can handle it, participate. those who can't, don't.



religion is another matter. that one does not bear the scrutiny of the standard rules of rational argument. you can't discuss it when there are no facts. no matter which side on which you fall, the argument cannot be supported by definitive proof.



politics though, has been shown to bring out some of the sharpest minds in the membership. sure, we get the occasional irrational hothead, but by and large the arguments and discussions are quite civil and often very informative.



fatboy - every one of my employees is working without insurance. that's the nature of the industry. we work shows by the day, but most of them don't work enough to be able to pay for insurance. many of them have been hurt before. those conditions prevented them from getting insurance. now, they all can. as a business owner, who hires casuals like that, i can tell you for certain that i stand a lot better chance of avoiding worker's comp claims.



the system is indeed broken. as i said, i don't think obamacare is the perfect solution either. but it's sure a step in the right direction, and a heck of a lot better than what we had. i'm sure up for other ideas, but i don't hear any coming from the right side of the aisle. all i hear are complaints. that's lame.



i agree that litigation should go away. however, how do you punish companies that take advantage? if we could criminalize such actions, and hold the CEO accountable with threat of prison, we might have something. until then, litigation is the only way to keep things in check. again, open to suggestion, but merely complaining does nothing positive.



if you're not a part of the solution, you're a part of the problem

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[Inkedupfatboy]

I know people need help - I have a mouth that is missing many teeth because an extraction was cheaper than a root canal at $1000 bucks a pop! I went years without insurance paying $20 bucks a month for an ER visit...but I am not convinced this is the answer....everyone around here is pretty dependent on tourism and snowbird income and they are putting everyone at part time positions because the business just can't afford the obamacare mandatory costs to provide insurance or to pay the fines if they don't.



I don't know what the answer is, but this ain't it

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