Medicare will soon be bankrupt.

[vivalostwages]

@Lightnin

You do realize, don’t you, that your post can be more easily summed up as, “Kill the poor”?

Some of the most active people I know are in their 80s and 90s. It’s not as if they’re all on life support. So I have a problem with cutting people off at a certain age.

[Damuri_Ajashi]

@Blalron

What we need to do, but probably won’t, is end “fee for service” health care. Pay doctors a fixed salary instead of for every procedure (which gives them a perverse incentive to order unnecessary tests).

Unecessary testing is a pimple on the ass of the medicare crisis. Most of us agree that there is some level of health care that everyone should have access to regardless of ability to pay but medicare sets that level very high indeed. We simply spend too much money trying to get very sick 95 year olds to their 96th birthday.

You can fiddle with compensation schemes all you want but we have tried everything from Kaiser type HMOs to coops to every other mechanism under the sun and as long as you are willing to have the government pay whatever it takes to keep your great great grandmother alive, you are going to become insolvent. The problem isn’t doctors and their pay, the problem is what the government is willing to pay for.

Its kind of like education. Most of us agree that there is some level of education that everyone should getr regardless of ability to pay and while we make some accomodations for students with special needs, we don’t provide private tutors for every public school student, we cram 30 of them into a classroom and if anyone wants better than what the system provides, they can go out pay for it themselves.

[Damuri_Ajashi]

@Bricker

This idea is laughable.

I agree there’s no shortage of people who want to be doctors and nurses, just as there’s no shortage of people who want to be NBA or NFL starters. There is a great shortage, however, of people that have the requisite talent and skills to serve in that capacity.

The problem is not “a shortage of programs.” I know we try to tell our kindergarten students, “You can be anything you want to be!” But that’s not really the truth. If you lack a certain base mental acuity, for example, you can’t be a doctor.

There is not a shortage of people who have the requisite skill and talent to be doctors and nurses, there is a shortage of people that have the requisite skill and talent to be a doctor or a nurse THAT WANT TO BECOME a doctor or a nurse.

[Kearsen]

@Damuri_Ajashi

There is not a shortage of people who have the requisite skill and talent to be doctors and nurses, there is a shortage of people that have the requisite skill and talent to be a doctor or a nurse THAT WANT TO BECOME a doctor or a nurse.

In the end, isn’t that really the same problem? I suppose we could offer incentives to doctors or nurses, oh wait, that would mean costs would go up…

Can’t have that.

[Damuri_Ajashi]

@Shodan

Tort reform includes things like reductions in defensive medicine and malpractice insurance, not just lawsuits. Cite - PDF. Although you are correct, it is not a panacea. On the other hand, it does not involve cuts in reimbursements or tax increases, and it decreases one of the upward pressures on costs.

It makes for fewer John Edwards types, but I consider that a benefit.

Regards,
Shodan

Based on the practices of doctors in states that already have tort reform on the book, the CBO estimates that federal comprehensive tort reform would reduce the cost to the health care system by less than 1%. What they did was look at costs and doctor behaviour in states like Virginia before and after tort reform capped liability and it turns out that is barely affects doctor behaviour at all. In other words the whole “defensive medicine” argument is pretty thin. If we have federal tort reform we will simply be doing it to appease a group of folks who don’t think the federal government should be getting involved in anything that isn’t listed in article 2 of the constitution never mind things that are historically the province of the states.

[Shodan]

@Damuri_Ajashi

Based on the practices of doctors in states that already have tort reform on the book, the CBO estimates that federal comprehensive tort reform would reduce the cost to the health care system by less than 1%. What they did was look at costs and doctor behaviour in states like Virginia before and after tort reform capped liability and it turns out that is barely affects doctor behaviour at all.

IOW, tort reform will reduce the cost of healthcare. If you want to reduce the cost of healthcare, and remove one of the factors driving up the cost of healthcare, what you say here is wrong -

In other words the whole “defensive medicine” argument is pretty thin. If we have federal tort reform we will simply be doing it to appease a group of folks who don’t think the federal government should be getting involved in anything that isn’t listed in article 2 of the constitution never mind things that are historically the province of the states.

We will be doing it to reduce the cost of healthcare.

Instead (apparently) we should pass Obamacare, which costs a shitload more and will not reduce the cost of healthcare. Why is that?

Regards,
Shodan