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Archive for Tuesday, March 23, 2010

Health care reform draws praise from area providers

While not perfect, bill provides solid foundation on which to build

Dr. Steven Bruner, of Lawrence Family Medicine & Obstetrics, confers Monday with patient Carol Glover. Bruner says he’s happy that the health care reform bill has passed. “I am very thankful that there are some politicians who actually have a little bit of courage to see this through really hard times.”

Dr. Steven Bruner, of Lawrence Family Medicine & Obstetrics, confers Monday with patient Carol Glover. Bruner says he’s happy that the health care reform bill has passed. “I am very thankful that there are some politicians who actually have a little bit of courage to see this through really hard times.”

March 23, 2010

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Those working in the Kansas health care industry lauded federal health reform legislation that is being signed today by President Barack Obama.

From doctors to Kansas Insurance Commissioner Sandy Praeger to an insurance representative, everyone seemed to agree on these four things:

  1. It’s a historic step in the right direction to fix a system that is greatly flawed.

Dr. Steven Bruner, of Lawrence, said, “It is just embarrassing as a citizen of this country to think that people are dying and going bankrupt because we can’t devise a health care system that gives everybody access to care.”

  1. It will need further work in addressing a number of issues such as tort reform and containing costs.
  2. If you have health insurance and you are happy with it, the bill won’t change your care or coverage.
  3. There’s still a lot of work to be done at the federal and state level.

“The devil’s going to be in the details going forward,” Praeger said.

Here’s what some of our area’s health care leaders had to say Monday:

Area health care experts react to health care reform bill

Lawrence-area health care professionals had mixed reactions to the sweeping health care reform that passed Sunday night in the U.S. House Enlarge video

Sandy Praeger — Kansas Insurance Commissioner

“It begins to fix problems in the marketplace that have to be fixed,” she said. “First of all, we have to get everybody covered in some fashion through Medicaid expansion or by reforming the rules in the marketplace, so people who need coverage can get it.”

Some of those rule changes take effect in six months.

For example, children and young adults up to age 26 can remain on their parents’ insurance plan. Insurance companies can’t have lifetime caps on coverage. They also can’t deny coverage to children with pre-existing conditions.

Praeger said the most important provision in the bill won’t kick in until 2014, when insurers won’t be allowed to deny coverage to anyone based on pre-existing conditions.

To do that, the bill requires everybody to have coverage.

The problem that Praeger expects is that the insurance costs for young, healthy adults are going to be higher than the penalty for not having insurance.

“I anticipate younger folks will pay the penalty and opt out, meaning we will lose one of the benefits of requiring everybody to have coverage and that is for healthier folks to buy coverage and help spread the risk,” she said. “That may not happen and that’s unfortunate.”

But Praeger hopes that will change in time. “There are still lots of areas that are up in the air,” she said.

Praeger is pleased the bill keeps regulations and oversight at the state level. She will be working with the U.S. Department of Health and Human Services on developing standards for the new state health insurance exchange.

Consumers are going have better information to compare policies, she said. The legislation also has added consumer protections. For example, the appeals process will include an internal and external review.

“It’s a start in terms of fixing the problems that do exist,” she said. “We can’t continue under our current system. We just have more and more people not being able to afford health insurance and that pushes the cost onto the insured population, meaning that more and more people can’t afford insurance. It’s not perfect, but nothing usually ever is.”

Dr. Steven Bruner — Lawrence Family Medicine & Obstetrics

Bruner, who has been a Lawrence doctor since 1976, said the health measure doesn’t solve all of the problems, but it’s an “excellent first step.”

“I am amazed that it happened and I am ecstatic that it happened,” he said.

Bruner said it creates a system that everybody can get into, which is key to holding down premium costs.

“When things get expensive, the people who drop are those who are healthier. Then, the pool is only left with those who are sicker and the rate has to go up,” he said. “If you can dilute the pool, which this legislation is designed to do, then you have a fighting chance to hold down costs.”

Bruner is hopeful that Congress will pass some provisions to the bill that will reimburse doctors who accept Medicaid at the same level as for Medicare, since it will expand the Medicaid program to cover more low-income people.

“You can live on Medicare, but you can’t live on Medicaid,” he said.

Bruner’s practice has six doctors. They each see about 100 Medicaid patients and they lose money on each of them. He estimated Medicaid pays half of what Medicare does.

He said boosting the reimbursement rate might increase the number of doctors who accept Medicaid and help lure medical students into primary care.

“Graduates will look at it as a more viable profession,” he said.

He said getting rid of the pre-existing condition exclusion is an important piece of the bill because it allows people to move to different jobs without fear of losing coverage whether they have diabetes or have had cancer.

If people don’t have coverage and that cancer returns, they often end up claiming bankruptcy.

“This bill is certainly not the best of all worlds, but it creates a much better system than what we had.”

Corrie Edwards — Kansas Health Consumer Coalition executive director

Edwards said the bill should provide insurance coverage for 230,000 Kansans by making insurance more affordable and by expanding the Medicaid program. There’s also a number of consumer protections.

“Plans can no longer terminate you if you get sick, and they have to let you in if you have a pre-existing condition,” she said.

Edwards believes the legislation has bumped up the importance of her job in educating consumers about their choices and rights.

She said work is still being done at the federal and state levels, but she is glad some reform has passed.

“I run a nonprofit, small business,” she said. “We’ve got a really good health plan. I am a cancer survivor. If I thought there was any way in the world it would jeopardize the health plan that I have, I honestly would not have advocated for it. I do not see this jeopardizing anybody’s current health insurance plans. I do not see that happening.”

Mary Beth Chambers — Blue Cross and Blue Shield of Kansas spokeswoman

The company, which insures about 902,000 Kansans, will spend the next several months making sure it complies with new federal regulations.

“It’s good to move past the rhetoric stage and get to that period where we can really get down to work,” she said.

Chambers said the company has endured a lot of changes in its nearly 70 years of business.

“When Medicare came into existence in the mid-’60s, people thought private insurance would go away at that time. That wasn’t the case at all,” she said. “We have every intention of remaining a viable insurance company for Kansans. So, we see that there’s great opportunity for growth.”

She said the legislation will allow more Kansans into the health insurance market, which will help spread the costs.

In January 2011, the legislation will require insurance companies to pay back 80 percent to 85 percent of premium health care claim expenses. Chambers said that wouldn’t be a problem for them because they already operate on less.

“With our business in 2009, we operated on less than 9 cents of a premium dollar. We paid back more than 91 cents in the form of health care claims,” she said. “We will do everything we can to keep that 9 cents low, but the true driver of health care costs is the 91 cents.”

Chambers said that hopefully premiums won’t go up, but they could because the legislation didn’t address costs of services and demand for services.

“Until we can work toward having more Kansans make healthier choices about eating right, moving more, smoking less — those sort of things to help combat chronic conditions that are frequently caused by lifestyle choices — that’s not going to control that cost factor too much,” she said.

She said premiums could be affected in 2014 when they no longer can deny anyone coverage who has a pre-existing condition. She said that works as long as everyone carries insurance.

“The jury is still out on whether the health care reform truly lowers the cost or increases the cost,” she said.

Gene Meyer — Lawrence Memorial Hospital CEO

Meyer described the overall premise of the bill — to provide coverage for those who are uninsured — as very positive.

But he has concerns and questions.

How much will the hospital and its providers be reimbursed for covering more Medicaid patients? It gets only about 20 percent to 30 percent of the costs now.

And who is going to provide care for the millions of people who will qualify for insurance?

“That’s really going to hit home at the primary-care-position level,” he said.

For people who have insurance, he thinks they may have to wait longer to see their doctors because of the newly insured population.

Meyer has heard that one way to financially support the bill is to reduce payments to hospitals and doctors.

“We are trying to figure out if the reduction in payments will be offset by the increases in payments when people become insured,” he said. “It’s going to be real interesting. I think how we are going to financially support such extreme measures longterm is going to be very challenging both to the health care industry and to the general public.

Nikki King — Health Care Access clinic executive director

King said the legislation is good news because fewer people will have to rely on the Lawrence clinic for medical care. It serves low-income, uninsured Douglas County residents.

Since opening in 1988, business has escalated. Last year, it served 1,431 patients, up 58 percent from just five years ago.

“Ultimately, the goal has always been for the clinic to go out of business, hoping that everyone has a medical home, a medical card, medical insurance — somewhere to go,” King said.

“The bad news is, according to this plan, it has only reduced our target market by half.”

So instead of having 14,000 uninsured Douglas County residents, there will be 7,000.

More people will gain access to coverage through more affordable plans or by qualifying for the Medicaid program, she said.

“There is the concern, of course, about whether there are enough providers who will take those cards. So we will see how that plays out in three years when this is fully implemented,” King said. “We will do business as usual until then.”

Comments

Flap Doodle 4 years ago

Your tax dollars at work. “Illegal immigrants likely would become the largest patient pool of the Harris County Hospital District as a result of health care reform unless the taxpayer-funded institution can attract more insured patients than it currently serves, according to public health experts. Hospital district President David Lopez said he's optimistic the district can better market itself to capture a larger percentage of covered patients but acknowledged that even if the district is successful, it must prepare for major shifts that will come with the landmark legislation President Barack Obama signed into law Tuesday. “With more people qualifying for coverage beginning in 2014, some of whom will go to other hospitals for their care, there will be questions about how to best maintain our payer mix,” Lopez said. “Certainly, the undocumented will become a bigger proportion of our patients who don't have insurance.” Illegal immigrants currently account for 18 percent of the district's patients….” http://www.chron.com/disp/story.mpl/health/6927229.html

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porch_person 4 years ago

notajayhawk,

(laughter)

Now I'm sure you're garfinkeling.

Misquoting multiple times, Denying that the United Nations and the OECD measure any other parameters than infant mortality and longevity. Asserting that you've posted data when you haven't. Simple contradiction. Repetitive denial of meaning with no basis for it. Garfinkeling.

I told you when we started. The data isn't going to change. Why you would want to bring up a debate which will have the exact same conclusion is beyond me, especially since you're on the losing end. You'll only get mad and start to name call and that's exactly what happened.

(laughter)

It is amusing to watch a "licensed mental health professional" decompensate over the course of days in front of everyone. That is funny.

(laughter)

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notajayhawk 4 years ago

porch_person (anonymous) says…

"I see you're still misquoting me. That's funny!!"

I provided the links to your posts, troll. That's hardly a misquote. At least YOU quoted Pilgrim exactly when you stole his post.

"Clearly you can't contest the data from the United Nations, the C I A, or the O E C D. "

There is no data except the infant mortality figures and the longevity figures, which neither the UN or the OECD uses as measures of healthcare outcome.

You're not just mistaken here, the information has been presented to you dozens of times. You're a liar. All you'd have to do to dispute that is post a link. But you can't, can you?

Thanks for proving you have nothing relevant to the discussion of healthcare.

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cato_the_elder 4 years ago

Toe, one great figure in our history had a very healthy distrust of government, and supported and respected it only so long as it "governed" as little as possible. His name was Thomas Jefferson.

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toe 4 years ago

The biggest casualty of the health disaster is a further erosion of trust of government. Since we empower government, what does this mean? We are very close to a point where the majority of American do not trust, support, or respect, government. What this means for the future of the US is of great concern to me.

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JHOK32 4 years ago

Finally!!! It's been 10 long years since the middle class has had anything at all to cheer about. President Obama said this health reform will help millions of people finally get healthcare, instead of only the rich. Only those making over $250,000 per year will see new taxes - & that ain't me!! Thank you Geoge W for screwing this country up so bad that when re-election time came the voters couldn't get to the polls fast enough! Landslide victories for the Democratic Party from coast to coast. Hallellujah!! Thank you George!

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beatrice 4 years ago

I believe I just got carpal tunnel in my finger from scrolling past all of notajay's diatribes.

Good thing to know it now can't be held against me as a pre-existing condition should I change insurance companies.

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porch_person 4 years ago

notajayhawk,

The quote you're referring to is a Rasmussen Reports polling question meant to conflate the health care reform with a single payer system, an obvious falsehood.

It was a disingenuous and loaded question by Rasmussen to try and influence voters into thinking that the health care reform was going to be a single payer system. Like "death panels", the single payer falsehood was quickly refuted.

I pointed out the dishonesty of such a conflation and the only response you guys could make is that I didn't copy someone's byline. You were trying to reframe the question into "Who was quoting who", not "How dishonest is Rasmussen being in its polling methodology?"

The reason why you were trying to reframe the question is because you had no response to my charge that Rasmussen was being dishonest and biased in its polling methodology.

We've gone over this many times. It's an example of the BS you guys will attempt when you lose an argument. Garfinkeling, reframing the argument, tangential and irrelevant followups, etc, etc. Liberty_One behaves this way more than you do but you're a close second.

It's because you can't stay on point. See? You can't stay on point because you lose on point. Here we are talking about a dishonest Rasmussen conflation from months back while you're trying to restart an argument on health care systems you lost badly because you hadn't done your homework on your own source.

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porch_person 4 years ago

notajayhawk,

(laughter)

You're still wanting to reopen that can of worms, aren't you!!

(laughter)

I see you're still misquoting me. That's funny!! You're also demonstrating an ignorance of the word "garfinkeling" or perhaps (more accurately) engaging in garfinkeling yourself by "breeching" the rules of social communication via using the term incorrectly.

Clearly you can't contest the data from the United Nations, the C I A, or the O E C D. The only thing left for you to do is misquote, name call and garfinkel. Had you any data or any argument against the methodology and data collected by those organizations, you would have provided it but you don't. You just have BS.

(laughter)

No, notajayhawk, I'm not giving you "do-overs". You lost. The United States does not have the best health care system in the world and the state of health care in this nation is a condition which needs attention from our government.

(laughter)

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notajayhawk 4 years ago

Okay, since porch is never going to admit it:

This is the link to Pilgrim2's original post:

http://www2.ljworld.com/news/2009/sep/27/take-stand/#c1006960

And my reply, quoting the entire post:

http://www2.ljworld.com/news/2009/sep/27/take-stand/#c1006977

And here's one of porch's posts, trying to claim Pilgrim2 and I were talking about "public option" the whole time - he starts with "Here's what was said:", and then pastes in the entire post - except Pilgrim2's byline - and finishes with "See, notajayhawk? You were responding to my comment to Pilgrim2":

http://www2.ljworld.com/news/2009/nov/21/nation-has-right-ask-why/#c1059769

He later said that using the whole post without the byline was inconsequential. Go ahead now, troll, whine to the moderators - again - because you were shown up to be a liar - again.

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notajayhawk 4 years ago

porch_person (anonymous) says… "Our health care system doesn't "drive" our infant mortality rate" March 5, 2010 at 5:18 p.m.

porch_person (anonymous) says… "The better the health care system, the more infants survive per capita. " March 23, 2010 at 6:07 p.m.

I lost track, troll - were you garfinkeling the first time, or the second?

Hey porch - here's one of those questions you were asked dozens of times and never answered (and I finally had to provide the answer to you myself): What's the leading cause of infant mortality in this country, and how is it affected by the healthcare system?

(Pssst - porch_troll - the answer to the first part is in your precious wiki.)

"That's why those institutions use those parameters."

Provide the link. (Not the link to the rankings, troll, the link to where it says either the U.N. or the OECD uses infant mortality or longevity as measures of health care "outcomes".)

What?

Can't?

Go figure.

"So I guess I won't be receiving an apology this Christmas from you for misquoting me and calling me a liar....."

No more than you'd get an apology for saying the sky is blue, troll.

"I wouldn't use one of Liberty_One's arguments as a basis for anything, notajayhawk. He's an admitted garfinkeler."

I sincerely apologize.

It was one of Pilgrim2's posts you stole.

You want me put up the link - again - to where you stole his post, then tried to weasel out by saying you didn't cut-and-paste the whole thing (what you accused me of doing), when you copied the entire post word-for-word except Pilgrim2's byline?

"I think calling me "a liar" multiple times does not further the discussion and violates the TOS. What say ye, moderators?"

I think your lying multiple times does not further the discussion and violates the TOS. What say ye, moderators?


beobachter (anonymous) says…

"porch, you have my respect. You spend so much time refuting the right wing ignorance such as nota. I don't tolerate pure ignorance that well."

So you agree with porchie?

Hahahahahahahahahahahahahahahahahahahahahahahahaha hahahahahahahahahahahahahahahahahahahahahahahahaha hahahahahahahahahahahahahahahahahahahahahahahahaha hahahahahahahahahahahahahahahahahahahahahahahahaha hahahahahahahahahahahahahahahahahahahahahahahahaha

Gee, BeO, thanks - I needed a good laugh. And just when I thought it wasn't possible to hold you in lower regard. (You were doing better when you had nothing to say at all, BeO.)

Hey, maybe you can help porch answer the questions he keeps ducking? Start with the one I just asked him about infant mortality. Watching the two of you put your heads together ought to be worth a million laughs.

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cato_the_elder 4 years ago

Beobachter, as far as ignorance is concerned you will recall my having educated you some time ago about the connection between your name and the infamous Nazi newspaper, the "Volkischer Beobachter." You'd never heard of it. Don't try to deny it - it's set in stone in earlier posts on this forum. Now I see that you've chosen a picture of Heinrich Himmler, the Reichsfuhrer of the SS, to sit in repose by your name. Do you have any idea how offensive that is? Do you know how many men and women gave their lives so that you would have the opportunity to type in English rather than German while sitting in your mother's basement? Do you not understand that this just isn't something that patriotic Americans joke about? Why do hard leftists like you get snot-nosed when reasonable people point out how fascism is an integral part of the Hard Left's agenda in this country today, from the faculty lounge Marxist-in-Chief on down? Your choice of photo proves just that and should embarrass you, but you wallow too much in pure ignorance to understand why.

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Benjamin Roberts 4 years ago

Wow - what a typo mess! Should read: @ beo - You knew Jonathan was too nice to make the smart alec comments that I make. ☺

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Benjamin Roberts 4 years ago

@ beo - You knew Jonathan was too nice to for the smart alec comments that I make. ☺ :-)

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Jonathan Kealing 4 years ago

Nope. Did_I_Say_that is someone else entirely.

I have two user accounts (one that I use, this one), and another that I use when I need to see how things look for users who aren't staff, superusers. I don't believe I've ever posted a comment using that account, which is jrk.

Jonathan Kealing Online editor

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beobachter 4 years ago

Jonthan. are you posting as Did_I_Say_that quoting policy?

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Benjamin Roberts 4 years ago

Use Policy Agreement By using this Web site's user-contribution features, including comments, photo galleries, or any other feature, you agree to abide by the terms of this agreement...

Users who engage in the behavior of continually misusing quotation marks (" ") and/or parentheses "()", and the word "laughter" in parentheses "(laughter)" may be banned and their account and contributions removed.

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beobachter 4 years ago

porch, you have my respect. You spend so much time refuting the right wing ignorance such as nota. I don't tolerate pure ignorance that well. The exact reason I can't stand Tom, cato, snap and those who display that same type of pure ignorance,

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porch_person 4 years ago

Guitarguy,

Are you saying that Dr. Bruner isn't a physician? Wildly inaccurate claim if you are.

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guitarguy 4 years ago

This comment was removed by the site staff for violation of the usage agreement.

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porch_person 4 years ago

notajayhawk,

(laughter)

"Oh yeah, I forgot, you're the one that believes in complete quotes - like the time you stole one of Liberty's posts and stripped off the byline to pass it off as yours, trying to look like you were on the right side of ahat argument. Yep, you just ooze integrity, troll." ---- notajayhawk

So I guess I won't be receiving an apology this Christmas from you for misquoting me and calling me a liar.....

(laughter)

I wouldn't use one of Liberty_One's arguments as a basis for anything, notajayhawk. He's an admitted garfinkeler. I bet if you dredged up that argument and presented it to the class, it would make you look foolish.

(laughter)

I think calling me "a liar" multiple times does not further the discussion and violates the TOS. What say ye, moderators?

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porch_person 4 years ago

notajayhawk,

(laughter)

The better the health care system, the more infants survive per capita.

The better the health care system, the longer people in that population live.

That's why those institutions use those parameters.

Get it? You're arguing that there is no correlation.

That's stupid.

(laughter)

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notajayhawk 4 years ago

porch_person (anonymous) says…

"What's incredibly funny is watching you misquote me and then state that I'm the one behaving without integrity."

Oh yeah, I forgot, you're the one that believes in complete quotes - like the time you stole one of Liberty's posts and stripped off the byline to pass it off as yours, trying to look like you were on the right side of ahat argument. Yep, you just ooze integrity, troll.

"Quite a bit of difference, isn't there, Mr. Integrity."

Well, yes - you have succeeded in making yourself look even stupider. What you just said is that infant mortality isn't driven by the healthcare system, yet somehow it still is an outcome measure of that system. Thanks for the whole quote - I couldn't possibly make you look any worse than your own words do.

"No, we've already covered that as well. Your own source, O E C D, has many different parameters for comparing health care systems. Infant Mortality Rate and Longevity are just two of the most commonly used."

And this time, again, I will simply call you a liar. Neither the U.N. nor the OECD uses infant mortality or longevity as measures of healthcare outcomes. I posted the entire list from the OECD that they use as outcome indicators, and since neither measure was included, you (laugh)ed it off. As a matter of fact, you have yet to back up your claim that ANY agency uses those figures as "outcome" measures. Both the U.N. and the OECD use infant mortality and longevity as measures of a population's "health, not as measures of health care*, as I have already posted several times. And you read, and responded to those posts.

Again, you're a liar, (laugh)ing boy.

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porch_person 4 years ago

Apologies. I meant to edit this statement a little better.

"Still have a basis for calling me "a liar" or is are you on the cusp of further violations of the TOS?"

should be

"Still have a basis for calling me "a liar" or are you on the cusp of further violations of the TOS?"

Again, apologies.

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porch_person 4 years ago

notajayhawk,

(laughter)

"And while we're talking about 'integrity' (you may want to look up the meaning of that word, since it's a foreign concept to you), did you or did you not say that health care does not drive infant mortality rates?" ----- notajayhawk

(laughter)

What's incredibly funny is watching you misquote me and then state that I'm the one behaving without integrity.

(laughter)

====

Here's how you quoted me recently on another thread :

"porch_person (anonymous) says… "Our health care system doesn't "drive" our infant mortality rate" March 5, 2010 at 5:18 p.m.

http://www2.ljworld.com/news/2010/mar/21/congress-approves-historic-health-care-legislation/#c1190958

======

Here's what the full quotation is:

"Our health care system doesn't "drive" our infant mortality rate but the fact that our infant mortality rate isn't better is an indication that we should look for ways to improve our health care system." ---- porch_person

(laughter)

Quite a bit of difference, isn't there, Mr. Integrity. Still have a basis for calling me "a liar" or is are you on the cusp of further violations of the TOS? You seem to be challenging the moderators to slap you down again.

(laughter)

======

"Without mortality rates, what evidence have you given - ever - to suggest other countries have better "outcomes"? Oh, that's right - absolutely none." --- notajayhawk

No, we've already covered that as well. Your own source, O E C D, has many different parameters for comparing health care systems. Infant Mortality Rate and Longevity are just two of the most commonly used.

Remember, you don't consider mortality to be an outcome.

(laughter)

Your problem is two fold. You don't like where we stack up in those assessments and you have absolutely no information with which to refute the data or the methodology of United Nations, the C I A or the O E C D. A point I've made before, to your ruin.

The last time you tried to bring a source to the discussion, your source agreed with my sources. That sent you into quite the display, a display which included violations of the TOS.

(laughter)

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notajayhawk 4 years ago

ferrislives (anonymous) says…

"Concerning what this bill will do for consumers, there are two that really stick out to me as positive things: - Insurance companies cannot drop customers who get sick - Insurance companies cannot deny potential customers based on pre-existing conditions"

As I said in my post.

And I have no problem with that. Why did we need the other 2,999 pages of legislation, or the trillion dollars in expenditures, to do that?

"Besides being unethical, those Americans were forced to use the ER's to get any kind of help, while a lot of them couldn't cover the bill. Because the ER's of America became a lot of people's doctor's offices, those uncovered bills got passed on directly to us taxpayers."

Actually, I remember someone posting a link to a study recently that said most of the people who use the ER for their doctor's office HAVE insurance. For many people, if they have the choice between seeing the doctor during the day or staying at work and going to the ER after work, they'll pick the ER if they don't have to pay for it.

"In addition to that, it's a known fact that Americans who get preventive care in the first place are healthier people, which ends up costing taxpayers less in the long run as well."

This is both true and false. Yes, if a serious condition is caught when it's still a sniffle, it's cheaper to treat. But if everyone goes to the doctor for every sniffle, costs skyrocket.

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notajayhawk 4 years ago

porch_person (anonymous) says…

"You stated that the just-passed legislation "removes the incentive any of the three players in the market (providers, consumers, reimbursers) to hold down costs, and two of the three have an incentive to increase them.""

"You said that, didn't you?"

Why, yes, I did, porch. I also said this:

"Physicians and hospitals have a financial incentive to provide more services "

Listen, if you don't know what the post you're replying to is saying or you don't have the integrity to admit it, don't pretend that you weren't making things up.

By the way, porch - and I've asked you this before, too, which you've never answered - who is this "we" you're speaking for?

And while we're talking about 'integrity' (you may want to look up the meaning of that word, since it's a foreign concept to you), did you or did you not say that health care does not drive infant mortality rates? Without mortality rates, what evidence have you given - ever - to suggest other countries have better "outcomes"? Oh, that's right - absolutely none.

And where, in this legislation, is there anything to reduce costs, porch? Still trying to pretend you've read any of it - let alone have the capacity to understand it? Why are you trying to argue with the CBO and the Kaiser foundation, who both say that insurance premiums will continue to rise under this 'reform'?

By the way, since your reading comprehension is so poor, let me be clear on this - I'm calling you a liar, porch. Now run off and whine to the moderators like a good little troll.

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ferrislives 4 years ago

notajayhawk (anonymous) says… "Soooo ... we can't afford to do this, but the Republicans should have done this. Um, okay." My point is that of course it's going to cost money to deal with it. But while some of the GOP had some decent ideas about addressing how the insurance and prescription companies are gauging its consumers, none of them acted on their ideas when they could have done so. It's their loss, and now their whining about what had to eventually be addressed.

"Now that you're done with your 'it's all the Republicans fault' (conveniently forgetting that the Democrats have never done anything about it either), would you care to explain how this legislation will do anything to slow, let alone reduce, the "ridiculous rise in health care costs" or in any way rein in the biggest beneficiaries of this legislation, the insurance companies?" I'm not going to fall into to the all-too-common "it's all the Republicans fault" crap, but it's obvious to everyone that they made the choice to spend a lot of our money on their own pet projects over 8 years, while the rising cost of health care was never addressed. That IS their fault, because it was during those 8 years that health care costs truly went out of control. Sure the Dems should and could have done something as well, but I don't hear them whining right now. I hear them celebrating the fact that they actually got something done.

Concerning what this bill will do for consumers, there are two that really stick out to me as positive things: - Insurance companies cannot drop customers who get sick - Insurance companies cannot deny potential customers based on pre-existing conditions

Those two items have been unfair practices for too long, and I'm glad that they were finally addressed. Countless Americans got limited treatments if they could afford even that, and a lot of them ended up dying because of those practices.

Besides being unethical, those Americans were forced to use the ER's to get any kind of help, while a lot of them couldn't cover the bill. Because the ER's of America became a lot of people's doctor's offices, those uncovered bills got passed on directly to us taxpayers.

In addition to that, it's a known fact that Americans who get preventive care in the first place are healthier people, which ends up costing taxpayers less in the long run as well.

I know those examples will not be enough for you, and that's really too bad. But as a Christian, I DO care about those people.

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porch_person 4 years ago

notajayhawk,

You stated that the just-passed legislation "removes the incentive any of the three players in the market (providers, consumers, reimbursers) to hold down costs, and two of the three have an incentive to increase them."

You said that, didn't you?

Listen, if you don't know what you're saying or you don't have the integrity to stand behind it, don't pretend that we are making things up.

======

Awful hard to drive costs up if your patients are healthy, isn't it, notajayhawk? Pretty hard to drive costs up if your patients don't want to be sick? Both health care provider and patient are working towards the same goals: health.

What scares me is what your goals are in your workplace.

This whole legislation is geared towards driving the cost of the most expensive health care system in the world down. You're claiming things will get worse. They won't. We have real world examples of universal health care systems which outperform us in cost and outcome. I know that you are aware of them because that's the data (from one source you yourself provided) that has sent you into a pathological decompensation of a grand scale.

I could beat you over the head with the data from the United Nations, the CIA and the O E C D but I did that the last time and all it returned for you was you getting your posts removed because you went psycho.

Why in the world you would want to repeat an exchange like that, (when the data certainly isn't going to change), is beyond me but I've suspected that you have some issues and you certainly provide the clinical support for that diagnosis.

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notajayhawk 4 years ago

porch_person (anonymous) says…

"Do you really think that providers don't want their consumers to get well? Do you really think that consumers want to get sick so that they can drive costs up?"

And I said that, where, again? Oh, that's right, I didn't - you made it up, like most of your posts.

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porch_person 4 years ago

"the just-passed legislation removes the incentive any of the three players in the market (providers, consumers, reimbursers) to hold down costs, and two of the three have an incentive to increase them." --- notajayhawk

Do you really think that providers don't want their consumers to get well? Do you really think that consumers want to get sick so that they can drive costs up? Do you really think that reimbursers haven't been milking the system before now? The reimbursers have been fighting this particular piece of legislation precisely because they aren't going to be able to milk the system like they have in the past.

Jeez, talk about naive!!

What kind of a "licensed mental health professional" are you? One who doesn't care for his patients? Is is all money to you?

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notajayhawk 4 years ago

Oh, and I forgot - in a market society, the insurance companies can't just increase their payouts to jack up their premiums, because that would drive some people out of the market - i.e., eventually it would reach a point where people just couldn't afford to buy insurance.

But now they have to, don't they?

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notajayhawk 4 years ago

[continued]

Because they don't have to - and because the patients don't ask. Who cares if that medication costs $20 or $500 when your co-pay is the same? Who cares if you get an x-ray or a CT scan at the emergency room if your co-pay is the same? Too many people never see what their health care COSTS - they have no idea that an ER visit can cost as much as a new car, that even a minor operation can cost more than they paid for their house. They only see their co-pays and, later, down the road, their premium increases - but they blame the insurance company for that.

Physicians and hospitals have a financial incentive to provide more services (and also litigation-avoidance incentives). When the doctor in the ER says he's sending you for a CT scan - a repeat of one you just had two days ago, which was a repeat of one you had three days before that - if you don't question the need for that scan, if you don't ask for a cheaper med that has a generic rather than the latest 'wonder drug' the pharmaceutical rep was pushing that week, you have no business complaining about the increase in your premiums several months from now.

And now, of course, more people will have insurance, which means there will be even fewer people that even pay attention to their bill, let alone try to reduce it.

The only ones that have any incentive to hold down the costs of health care delivery are the insurance companies, because of, like it or not. (To a lesser extent, public insurers like Medicare also have some incentive, because now, unlike in years past, they can't just ask the legislature for more money, 'cause the money isn't there.) Unfortunately, the legislation just signed changes that.

The legislation includes a provision for setting a minimum 'loss ratio' for insurance companies - i.e., the percentage of premiums collected that has to be paid out in claims. First, it accomplishes nothing, since the percentages set are already those typical of the industry. But more importantly, it removes any incentive to hold down health care costs. With the minimum loss ratio in place, any reduction in claims paid means insurance companies also have to lower their salaries and profits. Um - why would they do that? As a matter of fact, the incentive changes to one where they want to increase payouts as much as possible, since that allows them to increase their premiums and make a higher profit.

So, in short, the just-passed legislation removes the incentive any of the three players in the market (providers, consumers, reimbursers) to hold down costs, and two of the three have an incentive to increase them. And that third member - that would be us, the consumers - will be the ones stuck paying for it.

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notajayhawk 4 years ago

average (anonymous) says…

"And, honestly, do you think it's the costs of routine office visits that are driving the costs of healthcare? They're a raindrop in the ocean. Most of the costs of the system are 'catastrophic' ones."

Um - wrong. Obviously 'catastrophic' illnesses cost a lot more than routine office visits - but there are an awful lot more routine office visits.


vertigo (Jesse Crittenden) says…

"What if the thing driving the COSTS is how we pay for it?"

Well, it is - just not in the way you think - or in a way that this legislation will help (actually, it will make things worse).

It's not insurance company profits that are the problem, despite all the attempts to vilify the insurance companies. Take out that 3% and you still have trillions of dollars in health care costs. And it's not administrative costs, either - when you look at per-person costs, Medicare has higher administrative expenditures than private insurance companies. And the administrative costs for private insurers are costs incurred in the process of holding down payouts.

The problem is that with third-party insurers, public or private, nobody has any incentive to hold down costs. Not providers, not consumers. Read the section of Dr. Bruner's website I posted this morning: "If you let your doctor know about your financial constraints, he or she often can reduce your testing and drug costs, such as by prescribing less expensive generic drugs or, if possible, by supplying you with free samples of drugs." Um - why don't they offer those same cost-saving options to their patients that HAVE insurance?

[continued]

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Ray Parker 4 years ago

Americans refused to accept socialized medicine for decades, and now it's here, with all the bribes, pork, and shady deals. Ain't it great, Komrades?

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average 4 years ago

@rdragon - Again, on tort reform... what do you propose that's more strict than what Kansas already did a decade ago on caps? We already did tort reform. As have most other states. Hasn't done crap.

And, honestly, do you think it's the costs of routine office visits that are driving the costs of healthcare? They're a raindrop in the ocean. Most of the costs of the system are 'catastrophic' ones.

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Roland Gunslinger 4 years ago

What if the thing driving the COSTS is how we pay for it?

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notajayhawk 4 years ago

[continued]

Did you get a president who fulfilled his promises for bi-partisanship and transparency? No - you have C-Span, of all reporting agencies, talking about closed-door back-room deals, the president reneging on his promise to include the Republican proposals from his dog-and-pony show, and a rift that hasn't been seen since the Civil War, with 38 states working on legislation to negate the effects of this law. A law that was forced down our throats against the will of the American people, paid for by a lot of payola with billion-dollar payoffs in pet projects to Democratic legislators. All led by a president who's proven beyond a shadow of a doubt that the 'change' he promised was more of the same, and that he cares more about his own image than about the will of the people who elected him.

The only thing any of you can point to is that more people will have insurance. (Of course the medical community is celebrating - that means more money in their pockets.) Of course, many of the now-insured, if not most of them, weren't people who didn't have access. They were people who chose not to carry insurance, because they didn't need it. The only reason they'll be carrying it now is because the government will fine them if they don't.

Oh, there will be some people who will now have access to insurance that didn't before, like those with pre-existing conditions. Here, let me fix that:

"No provider of Health Insurance to the public shall deny coverage to any person based on the existence of pre-existing health conditions."

Gee, that didn't take 3,000 pages.

One MORE time, for the slow folks - it's not how we pay for health care that's the problem, it's that health care costs too much. Without addressing the COST (and there is absolutely nothing in this bill that does that even begins to address that), finding different ways to pay for it is pointless and unsustainable. If we get the COSTS under control, how we pay for it becomes irrelevant.

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porch_person 4 years ago

notajayhawk,

Bartstop's contributions to the forum are one hell of a long way from "drivel" and 'fear-mongering".

Will you keep the screeds down to a dull roar?

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notajayhawk 4 years ago

kbritt (Karrey Britt) says…

"All of them said it was a "step in the right direction" and none of them are happy with the bill as is."

In other words, the best the Democrats could do was to pass something - something nobody's happy with - just to say they passed something.

To all those interviewed, to all those who have posted messages here saying this bill is a 'step in the right direction', let me ask: If this 'first step' took 3000 pages of legislation and a trillion dollars, what is 'real reform' going to cost?

And again, to all of you first-steppers (who have been denying for a year that this was a 'first step' towards a bigger government takeover of the health care system), I'll just repeat the question I've posed on two other threads, since nobody seems to want to answer it:

Exactly what you think you've "won"?

Did you get anything that will reform health care? No. There is not a single thing in any of the legislation that changes anything about health care, it just changes who pays for it.

Did you get anything that will bring down the costs of health care? Again, no. The CBO and others, such as the Kaiser Foundation, have said insurance premiums will continue to rise. With more people paying into the pool. The only ones that will be paying less will be those who get subsidies - paid for through higher taxes. Overall, our healthcare spending will continue to grow.

Did you get your precious nationalized health plan like they have in all those gee-whiz neato other countries that are so much better than ours? Nope, nothing even close. You didn't even get your public option, did you? (That question is not directed to porchie, who still thinks we got the public option - provided by private companies. That one's gonna' be good for laughs for years to come.)

[continued]

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notajayhawk 4 years ago

bartstop (anonymous) says…

"To all the GOPers that continue to bash the bill. You have many concerns, and you have every right to have those concerns. But, your party did not represent you. They refused to engage with the majority party."

Because that would have mattered sooooo much, right, bart? Like when they went to the president's dog-and-pony show, and the pres made a big deal about how he was going to include some of the Republicans' ideas in the final bill? Hmmm - seems like none of them made it.

They 'engaged' Ms. Snowe because they had to appear they were being bi-partisan. Perhaps because polls have repeatedly shown that the American people were against the passage of any legislation that had the support of just one party.

"If they were to somehow manage to get this bill repealed, how are they going to look? They are opposed to preventing discrimination based on pre-existing conditions? They are opposed to removing insurance caps? They are opposed to filling in the Medicare donut hole (that they created BTW)? The list goes on and on."

Well, first, they'd look like the party that was giving the people that sent them there what they asked for. As for the rest of your drivel, that's the same fear-mongering the Dems kept shoveling when Bush vetoed the S-CHIP package: 'If you don't accept THIS solution, right NOW, then you're in favor of poor children dying!' There's a way to fix the problem, but this isn't it, and the Republicans (along with a majority of the population) want it fixed right, in a fair and sustainable way, not just shovel through something unwieldy, unaffordable, and meaningless so Obama, Reid, & Pelosi can stand before the cameras and pat each other on the back.

They have backed themselves in to a corner once again. If the GOP is to ever come to power again, they must find new leadership. Backing yourself in to a corner is one of the worst things you can do politically. Failing to attempt a compromise is failing to respect democracy. The GOP is the poster child of Government Failure.

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bambi 4 years ago

Karrey, you say that Dr Goering volunteers for Health Care Access, what about Dr Bruner? Does he volunteer any of his time? How often?

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Tom Shewmon 4 years ago

"...contribute funds, and give of my time and energy to keep them in office."

Good idea smitty, they're gonna need all the help they can get. I think America can officially be placed in the "pissed-off" column, for the most part.

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smitty 4 years ago

Obstructionism be damned.

Our president has signed the bill.

History made!!

If the democrats can keep accomplishing advances for the average people, I will give up my independent voting registration and register demo, contribute funds, and give of my time and energy to keep them in office.

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Karrey Britt 4 years ago

The Medicaid reimbursement rate isn't just a concern for Dr. Bruner, but to Gene Meyer, Nikki King, Sandy Praeger and Corrie Edwards. Many of these interviewees said the same thing, so I didn't repeat what had already been said. I also tried to interview people who worked in all levels of our health system. When I called, I had no idea whether they would be happy with the legislation or not. All of them said it was a "step in the right direction" and none of them are happy with the bill as is. I also interviewed Dr. Goering and his interview can be found on WellCommons at http://wellcommons.com/groups/nosurance/news/2010/mar/23/area-health-care-leaders-/.

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porch_person 4 years ago

On to more important questions,.....

How does everyone like the "no beard" look Dr. Bruner has? I'm not sure I'm on board with that one. I think I liked him better with the beard.

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porch_person 4 years ago

vertigo,

That's not what akt2 is saying and that's not what Congress just passed legislation to address.

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porch_person 4 years ago

akt2,

Don't tell that to notajayhawk. He thinks there's some sort of secret reimbursement scheme. He knows more about the health care industry than almost anyone. Anyone who disagrees with him is "naive". He said so.

(laughter)

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Roland Gunslinger 4 years ago

akt2 (anonymous) says… Medicaid already sucks the life out of healthcare workers and hospitals. Physically because of the high volume of patients that they are already treating,


So your answer to this problem would be to deny them medical treatment. I see where the real "Death Panel" is.

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akt2 4 years ago

Medicaid already sucks the life out of healthcare workers and hospitals. Physically because of the high volume of patients that they are already treating, and financially because of the low reimbursements.

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porch_person 4 years ago

notajayhawk,

"It really doesn't matter which, porch, since I have no intention of getting insurance after this legislation becomes law. It will be cheaper or me to keep paying out-of-pocket and pay the fines." --- notjayhawk

(laughter)

Gee, that's wise.........

(laughter)

Here's to invincibility.

(laughter)

Can't understand how you keep losing arguments with mental processes like that.

(laughter)

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notajayhawk 4 years ago

porch_person (anonymous) says…

"Do I read a little "I can't afford insurance" enmity in your post, notajayhawk? I thought you were refusing it "on principle"."

It really doesn't matter which, porch, since I have no intention of getting insurance after this legislation becomes law. It will be cheaper or me to keep paying out-of-pocket and pay the fines. So sorry if that doesn't help freeloaders like yourself.

"Aren't you in the health care field? People who work in health care get insurance."

Proving once again that porch knows nothing - absolutely nothing - about the health care field.

"I would think someone like yourself, in the health care field, would be applauding Dr. Bruner for providing a service to the community without getting fully reimbursed. Dr. Bruner is the kind of member of the community that's desirable. Someone who gives back."

[Sigh] A mind - even such a tiny one as yours - is such a terrible thing to waste. It's such a shame you can't read, porch. If you could, you might see that Dr. Bruner is "giving" nothing. Dr. Bruner has two fee structures - he says as much on his website. He charges more to people who have insurance. He likes this legislation because more people will be able to pay him more money. And that's what a pea-brain like YOU finds "desirable"?

Oh, BTW, porch, if you think the good Dr. is not getting 'fully reimbursed', it only serves to demonstrate further your utter ignorance. Insurance companies typically reimburse at about 40% or less of the private-pay rate. Dr. Bruner offering a 20% 'discount' for cash brings in about twice as much as he gets from insurance companies for the same services. Of course, he soaks the insurance companies for more services (more tests, more expensive medications), so either way he makes out.

How long have you been this naive, child?

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notajayhawk 4 years ago

ferrislives (anonymous) says…

"I still can't get my mind around how we think that we can pay for all of these different programs and keep our deficit down, but in all reality, if the GOP had addressed the health care issue head on when they ruled both houses and the presidency, this wouldn't be happening. You can only hold your head under the sand for so long."

Soooo ... we can't afford to do this, but the Republicans should have done this. Um, okay.

"Everyone knows that the ridiculous rise in health care costs and unethical actions by health insurance companies needed to be addressed at some point, so stop whining, because you had your chance for 8 long years and chose not to take it. Now your worst nightmare is happening, and it's your own fault for not being more vocal about your ideas when your own people were in power."

Now that you're done with your 'it's all the Republicans fault' (conveniently forgetting that the Democrats have never done anything about it either), would you care to explain how this legislation will do anything to slow, let alone reduce, the "ridiculous rise in health care costs" or in any way rein in the biggest beneficiaries of this legislation, the insurance companies?

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porch_person 4 years ago

"Bartstop,

Your post is one of the best I have read in a long time. " --- Graczyk

I have to agree. I'm impressed with this blogger. I see Bartstop has been here since 2004. I feel some penalty must be imposed upon him/her for not posting enough. ;-)

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ralphralph 4 years ago

BC/BS says the bill wil "allow more Kansans into the health insurance market" It won't just ALLOW them in, it will force them in with a jailer's prod.

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Silly_me 4 years ago

I honestly hope this bill will have a positive influence on those who have posted here..whether for or against. I have discovered that this bill will have a negative consequence to me and my family. I have a medical condition that requires expensive medication with very high copays. Because of that and the way my company provided health insurance is structured, I took advantage of health care flexibile spending accounts to provide a bit of a break on these out of pocket costs. Every year, we would get pretty close to the $5000 limit. I've just discovered that this limit will now be reduced to $2500. Thus I'll lose that tax benefit. I guess somebody had to lose in this deal.

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porch_person 4 years ago

(laughter)

Do I read a little "I can't afford insurance" enmity in your post, notajayhawk? I thought you were refusing it "on principle". Aren't you in the health care field? People who work in health care get insurance.

(laughter)

I would think someone like yourself, in the health care field, would be applauding Dr. Bruner for providing a service to the community without getting fully reimbursed. Dr. Bruner is the kind of member of the community that's desirable. Someone who gives back.

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Benjamin Roberts 4 years ago

"Gene Meyer — Lawrence Memorial Hospital CEO ... has concerns and questions. How much will the hospital and its providers be reimbursed for covering more Medicaid patients? It gets only about 20 percent to 30 percent of the costs now. ... Meyer has heard that one way to financially support the bill is to reduce payments to hospitals and doctors."

"[Dr.] Bruner is hopeful that Congress will pass some provisions to the bill that will reimburse doctors who accept Medicaid at the same level as for Medicare, since it will expand the Medicaid program to cover more low-income people. “You can live on Medicare, but you can’t live on Medicaid,” he said."

Dr. Bruner has apparently moved from practicing medicine to practicing wish-craft.

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Flap Doodle 4 years ago

"Health care reform draws praise from the running dogs of our imperialist overlords" There, I fixed the headline for you.

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Graczyk 4 years ago

Bartstop,

Your post is one of the best I have read in a long time.

rdragon,

You propose a stupid game. If you want to make a point, why don't you pull the research on government programs and post it here. Don't ask us to do your research for you.

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Roland Gunslinger 4 years ago

rdragon (M. Lindeman) says… Those of you who are pro this bill, give one example of a goverment program that runs with in budget, just one.


1) The Bureau of Land Management who made a profit $3.4 billion in mineral rights leases and only cost $834 million to run.

2) The FCC who has a budget of $313 million, but made $19.6 billion in revenues auctioning off bandwidth in 2008.

3) The Tennessee Valley Authority - which had a profit of $817 million in 2008.

4) The U.S. Mint netted more than $1 billion in 2007 and $800 million in 2008 selling U.S. collectible coins at face value (because it costs them less than face value to make most of them).

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bendover61 4 years ago

Will the Journal World balance this article with a headline of providers that don't support the reform. Of course not, this is why I no longer buy the paper.

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christy kennedy 4 years ago

Wow. I just skimmed through an awful lot of paranoid and misinformed comments and also would like to thank bartstop and russell for their sane reactions to this article and to health reform in general.

Good lord people! Of course the bill isn't perfect — nobody's completely happy with it — you must have noticed how most are saying it's a first step or step in the right direction? Give this a chance. Of course a lot of details will have to be worked out but many, many decent and sincere people are working on it. Which of them do you think has evil intentions? Who do you think is doing this for some sort of (?) personal gain? I mean, really!

When the different features of this bill go into effect and how people access and pay for health care has truly changed, I know that a lot of angry Conservative lives will be improved and even saved. But I'd bet good money that some will still be mad as they are today.

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alm77 4 years ago

Bart, did you read David Frum this morning? I think you summed up his sentiments nicely. http://www.commondreams.org/view/2010/03/22-2

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ferrislives 4 years ago

I still can't get my mind around how we think that we can pay for all of these different programs and keep our deficit down, but in all reality, if the GOP had addressed the health care issue head on when they ruled both houses and the presidency, this wouldn't be happening. You can only hold your head under the sand for so long.

Everyone knows that the ridiculous rise in health care costs and unethical actions by health insurance companies needed to be addressed at some point, so stop whining, because you had your chance for 8 long years and chose not to take it. Now your worst nightmare is happening, and it's your own fault for not being more vocal about your ideas when your own people were in power.

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M. Lindeman 4 years ago

Those of you who are pro this bill, give one example of a goverment program that runs with in budget, just one. Oh and don't give me the percription drug program, because that is privately run. So just give me one, because not one of you supporters are truely for reform. If you really wanted honest reform, you would have screamed to kill this bill. As I have said, tort reform, routine office visits come out of pocket (then people would pay attention on cost) and catastrophic insurance.

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M. Lindeman 4 years ago

Those of you who are pro this bill, give one example of a goverment program that runs with in budget, just one. Oh and don't give me the percription drug program, because that is privately run. So just give me one, because not one of you supporters are truely for reform. If you really wanted honest reform, you would have screamed to kill this bill. As I have said, tort reform, routine office visits come out of pocket (then people would pay attention on cost) and catastrophic insurance.

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whats_going_on 4 years ago

bartstop and rrussell...well played, well played. :)

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BMI 4 years ago

Oops, I see the word nazi on the floor, did one of you haters drop it? ;)

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notajayhawk 4 years ago

"Bruner said it creates a system that everybody can get into, which is key to holding down premium costs."

Pretty amusing, doc, since the CBO, the Kaiser Foundation, and everyone else says that insurance premiums will continue to rise, not become more affordable. But then, that's not what you care about, is it?

See, the good Dr. Bruner is happy more people will be able to afford his fees now.

From the website of Dr. Bruner's practice:

http://www.lfmo.com/FAQs.htm

Q: I work full time but don’t have health insurance and find it difficult to pay my medical bills. Can you help me?

A: The doctors of Lawrence Family Medicine and Obstetrics understand and share the concern of many about declining health insurance coverage for many Americans. Our professional organization, the American Academy of Family Physicians, has worked hard to promote the passage of universal health insurance coverage in our nation for many years. (We urge you to help us by making your needs known to your elected representatives in Washington and Topeka.) Until legislation mandating insurance coverage for all Americans is passed, we will continue to try to help our patients who are not insured or who are underinsured get the care they need. For instance, we offer a 20 percent discount to cash- or credit-card paying patients. And, although we require payment at the time of service, we will work with you to set up payment plans for large medical expenses. If you let your doctor know about your financial constraints, he or she often can reduce your testing and drug costs, such as by prescribing less expensive generic drugs or, if possible, by supplying you with free samples of drugs. In cases of extraordinary or ongoing medical needs, we can refer you to Health Care Access, a clinic manned by volunteer doctors (including our own), which is able to provide markedly reduced-cost medical care.

In other words, if you can't afford healthcare, write to the government and force them to find a way to pay them. Don't expect ME to reduce my fees. Oh, we'll offer a 20% discount for cash - which brings it down to about, oh, twice what insurance companies pay. Oh, and we'll offer you fewer tests and cheaper meds (we'll just keep overcharging insurance companies for the difference). But if that's still too much, we'll be happy to kick you over to HCA.

It's doctors like the good Dr. Bruner that are the problem, and all this legislation does is give him more insurance companies to overcharge and the ability to maintain his unaffordable fee structure.

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Shardwurm 4 years ago

Wow. The Liberals are going to great lengths (including the Liberal Journal World) to sell us this bill of goods aren't they?

How about this - if it's such a great idea let those who think so pay for it.

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Rex Russell 4 years ago

We will have to see where this goes in the future. I am guessing at some point, there will be things about this legislation that I like and things I won't like. But from a political standpoint, I am thinking that the GOP is going to reap what they sowed in this one. The big political gamble of being petulent children instead of mature adults(Congress) is going to come back and haunt them. And please, for those out there about to say that they were shut out of discussion, it is plainly false. As it looked more and more like this could be a good thing, and even a reality, the strategy turned from helping shape the legislation with Republican ideas included, to the all-or-nothing strategy of "give them no victories and make them look incompetant." At that point, you no longer bring in people to work on a project that actually want to see it fail. That's stupid. You move on without them. In due time, when no one's grandma is killed by a "death panel". And when we don't turn into a "Socialist dictatorship". And when insurance companies aren't run out of business. And dead bodies aren't lying in the streets. Those who were preaching all the fear will look loke fools. And this will have turned out to be a foolish political gamble.

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75x55 4 years ago

"They refused to engage with the majority party."

After being shut out or lectured at on any occasion that presented itself? No, the more accurate wording you would be looking for is not 'engage with', but 'co-opted by'.

When driving off a cliff, it's not necessarily admirable for a passenger to insist on which exact place on the edge to aim for.

It is far more admirable for the passenger to bail out and take whatever abrasions and bruises that may hold, rather than accepting a nice comfortable ride to a blazing end.

Like this coming election day...

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M. Lindeman 4 years ago

jimincountry (anonymous) says… This country needs an enema....start with Washington DC and flush it through San Francisco.

rdragon writes: Well said, I second that.

ozzynbn (anonymous) says… My oncology doctor disagrees with statements like Bruner made. He told me he thinks Americans need some type of catastrophic coverage, but not full coverage. I agree with him. LMH has too many charity cases as is.

Next time elections roll around, look and see who's name is supporting Democrats. Bruner is almost always there.

rdragon writes:

I agree, if people really wanted proper reform that would work. They would get behind catastrophic insurance and office visit would be paid out of pocket. The other issue that would also bring down cost would be Tort reform, get rid of all the BS lawsuits. Addressing those issue would true health care reform, not another goverment run debockle.

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ozzynbn 4 years ago

Bartstop............... what's your problem with Republicans calling democrats who voted for the bill "liars" and "baby killers"? It's true. Didn't Obama promise transparency and renege? Isn't there funding for Planned Parenthood who helps women eliminate fetus's aka BABIES?

So...... Republicans are saying truths while democrats continue lying.

Your next gripe?

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ozzynbn 4 years ago

My oncology doctor disagrees with statements like Bruner made. He told me he thinks Americans need some type of catastrophic coverage, but not full coverage. I agree with him. LMH has too many charity cases as is.

Next time elections roll around, look and see who's name is supporting Democrats. Bruner is almost always there.

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macon47 4 years ago

BUNCH OF KOOL AID DRINKERS

forcing people that dont want or cant afford heath insurance is like forcing people who dont want to work to take jobs in order to solve unemployment

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TJ_in_Lawrence 4 years ago

Gee Dr. Bruner... seems to me that you have had the complete ability to cover anyone who walked into your office for the past 30 years. How many free exams and treatments did you give last year to the uninsured? I'm sure that the poor un-insured would love to live in your home, which was certainly not built by giving away free health care. Seems to be me that your happy that someone else now has to foot the bill while you still get paid. Why wouldn't you be ecstatic? Can you say hypocrite?

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jimincountry 4 years ago

This country needs an enema....start with Washington DC and flush it through San Francisco.

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David Albertson 4 years ago

To all the GOPers that continue to bash the bill. You have many concerns, and you have every right to have those concerns. But, your party did not represent you. They refused to engage with the majority party. They stood on the sidelines and screamed "you lie" and "baby killer". The only Republican to actively engage was Olympia Snowe. This process of the Congress, as outlined by the Constitution, is designed to create compromise. When the minority party refuses to participate in the process, and chooses to portray the other side as evil and socialist, they are compromising our democracy. If you want to point your finger at somebody for the failures in Washington, you should be pointing it at the GOP. They played politics with your healthcare. Now, we have a bill that had very little input from your party. You should be outraged that your elected representatives did not represent you. They gambled that this bill would fail and in turn, Obama would be a failure. Well, it blew up in their face. The GOP failed to stop this so called "government takeover", which isn't true BTW. So now, when the truth comes out over the next few months, when the sky doesn't fall, granny doesn't get the plug pulled, your insurance policy isn't cancelled, you're not forced in to a government run policy, etc., etc.. Their credibility will be in serious trouble.

If they were to somehow manage to get this bill repealed, how are they going to look? They are opposed to preventing discrimination based on pre-existing conditions? They are opposed to removing insurance caps? They are opposed to filling in the Medicare donut hole (that they created BTW)? The list goes on and on. They have backed themselves in to a corner once again. If the GOP is to ever come to power again, they must find new leadership. Backing yourself in to a corner is one of the worst things you can do politically. Failing to attempt a compromise is failing to respect democracy. The GOP is the poster child of Government Failure.

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toe 4 years ago

Local doctors will be a reporting source to the IRS on you when you use their services. You will not be able to trust your socialist health care provider.

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cato_the_elder 4 years ago

Beobachter, Bruner's views on national medical issues are hardly reflective of the Lawrence physician community at large. He's just another long-time committed leftist with a rather large axe to grind on any number of political issues, as has been repeatedly demonstrated in this newspaper. The physicians who disagree with him are generally too reticent to get embroiled in politics publicly, but Bruner appears to enjoy it a great deal.

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beobachter 4 years ago

cato, care to prove your statement that Bruner is not representative of majority of Drs point of view, Anyone can make wild claims without proof.

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Liberty275 4 years ago

"I anticipate younger folks will pay the penalty and opt out"

LOL. Hippies are gonna have to give their pot money to the fed in health care fines and get NOTHING out of the deal. Not even some schwagg.

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OonlyBonly 4 years ago

"scheme Pelosi has waiting in the wings." Oh, I'm sorry. I thought this was the idea of our great leader and president for change...........

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flux 4 years ago

Eveyone seems to be an expert on the matter yet no one seems to have anything original to say

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average 4 years ago

The synopsis mentioned 'tort reform', though none of the direct quotes did. I was kind of curious what any of them had to say on the matter, seeing that Kansas passed fairly strict tort caps years ago. As, to various degrees, have the majority of states. Seriously, when did the last multimillion pain-and-suffering malpractice suit make the news in KS? Not that rates seem to have stabilized a whole lot as a result.

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down_the_river 4 years ago

The greatest increases in health costs in the past decade has been with drug costs. The fact that Pharma spent $300,000,000 lobbying, donating and advertising in support of this bill, and has seen their stock prices soar suggests to me that they don't anticipate any reduction in the prices they will charge us. It seems there are few real cost reductions in this act, and we're simply delivering more customers to the greedy maw of the industry. And despite what the proponents have claimed, the evil ones here aren't the insurance companies. Look at the Blue Cross response in this column. A 9 percent profit is not greedy, and is meager in comparison with hospital and pharma profits.

Unfortunately, Massachusetts shows the foolishness of hoping for cost reductions in our premiums. Last month the announced increases in the state ranged from 7 to 34 percent, and they're asking for a half billion dollars from the feds to keep the program afloat. (And their insurance companies are losing money.) Not a happy model for us as a nation.

As for deficit reductions, that is based on the inclusion of cellulosic ethanol tax credit reductions and student loan program overhauls that were oddly included in this bill. It appears these were solely to achieve political cover to help keep this price tag for the bill under $1 Trillion. This bill is not what really what is being sold to us. Most of us won't like the long term results when both out premiums and taxes rise to cover the costs.

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davidsmom 4 years ago

If Medicaid and Medicare reimbursements go even lower, are doctors required to treat those patients? If so, how many young doctors will want to go into primary care? It is really sad. This year's Match Day saw an upswing in primary care residencies being filled, but that could spiral downward again. So if we have millions more people eligible for primary care and fewer providers, how does that work?

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Lindsey Buscher 4 years ago

It's clear to me that health care professionals know very little about health care reform and that the angry conservatards that post on the site know best.

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cato_the_elder 4 years ago

What Bruner says is in no way reflective of what the Lawrence physician community at large thinks of this corrupt excuse for legislation. And before the petty block commissars of Lawrence celebrate too much, the legislative process is by no means over. Let's see where this is legislatively two months from now, and then later after the United States Supreme Court has finished with it.

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Flap Doodle 4 years ago

Higher taxes, higher insurance premiums, higher deficits. Oh, jeepers. I just can't wait to see the next mad scheme Pelosi has waiting in the wings.

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LeannaBlanka 4 years ago

This comment was removed by the site staff for violation of the usage agreement.

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