<p>Oh I would Romani and I’m going to scope it out.</p>
<p>
You do know that Medicare claims are processed by fiscal intermediaries - private insurance companies, sometimes for-profit, because CMS realizes that it’s more efficient to subcontract it. Medicare also subcontracts a lot of audits to private contractors. Seriously, if someone says the government has 15-20% overhead and a private entity has 20-25% overhead, maybe you can believe it. But to believe that they are ten times as efficient as someone else - would you just accept that figure?</p>
<p>This is interesting for those of us who do not plan on early retirement but want to work at something:</p>
<p>[Seth</a> Godin?s Key to Success: ?Do Something Ridiculous? | Daily Ticker - Yahoo! Finance](<a href=“http://finance.yahoo.com/blogs/daily-ticker/seth-godin-key-success-something-ridiculous-183829636.html]Seth”>Seth Godin’s Key to Success: “Do Something Ridiculous”)</p>
<p>romani, I didn’t know that about Flint. How horrible. We get several Detroit tv stations on our cable and I happened to have one on when the 5:00 news started tonight. That’s when I heard that story about the murders for 2012. It saddens me. I had an actor friend who spent several months in Detroit last year with a show that was filmed in the city. I know that he liked the city and the people he met there very much. The production was also involved in a lot of charity work while there and were dedicated to doing what they could to contribute to the city and to the many residents who were employed by the show. Sadly, the show was cancelled after only one season.</p>
<p>Sorry to take the discussion in another direction. My apologies.</p>
<p>We change. What are we going to be like 10 years from now?
We don’t know.</p>
<p>[You</a> Can’t See It, But You’ll Be A Different Person In 10 Years : Shots - Health News : NPR](<a href=“You Can't See It, But You'll Be A Different Person In 10 Years : Shots - Health News : NPR”>You Can't See It, But You'll Be A Different Person In 10 Years : Shots - Health News : NPR)</p>
<p>“We change. What are we going to be like 10 years from now?
We don’t know.”</p>
<p>I’ll make a wild prediction, but don’t hold me to it. Fatter, dumber, and more wrinkled. At least I’m sure I will be.</p>
<p>That 1 in 542 is awful, romani. Wow, that is staggering.</p>
<p>“I’ll make a wild prediction, but don’t hold me to it. Fatter, dumber, and more wrinkled. At least I’m sure I will be.”</p>
<p>Hmmmm…luckily our eye sight goes too. :)</p>
<p>so, again for the pure purpose of discussion here.</p>
<p>A homeless person passes out on street from excessive drinking. he/she is in really poor health from bad eating habits and smoking. Should we as a society spend money to get that person to ER and run 100s tests to find out what are wrong with the said person?</p>
<p>“Hmmmm…luckily our eye sight goes too”</p>
<p>I am already thankful for that. I used to have 20/10 vision, and it drove me crazy that I was losing it…but now I’m okay with the vision going downhill.</p>
<p>I made a mistake. It’s not just last year, it’s over the last three years. Still appalling. I know plenty of people who won’t let their kids go to school there. They homeschool to keep them safe. Homeschooled by parents who generally didn’t finish high school themselves. Very, very depressing situation. </p>
<p>Anyway, I think this is part of the problem of the health care industry. I think they are related. We can’t necessarily model our health care system after another country’s because, quite frankly, we’re not like other countries. Could you imagine another country with the murder rates we have? And then the social problems that are associated with that- the poor education, lack of access to medical care, poverty, etc- all drives up the cost of our health care system. </p>
<p>I’d be shocked if the insurance rates in places like Detroit or Flint are anywhere near 50%. I recently wrote a paper about maternal health care in low income, urban areas. Even working with low income women for the last several years, I could never have imagined the statistics that I came across. Like the fact that we’re behind ~40 countries when it comes to pregnancy complications and maternal deaths. 40! And where are most of those located? In places like Flint and Detroit. Places where it’s very difficult to get adequate health care access and where there are extremely high rates of uninsured people. </p>
<p>Sorry for the rambling post, I’m very tired. My point is though that I think we don’t necessarily have just a health insurance problem- we have a major cultural problem that is driving up the cost of health care. There are many, many problems ranging from astronomical tuition to poor educational systems in many low income cities that, quite frankly, other countries with phenomenal health care systems don’t have to deal with to the extent that we do.</p>
<p>As many of you know, I am for universal health care. I just don’t think that’s our only problem or that it’s the solution to all of our problems. Our problems run far, far deeper than the ridiculous profits of health insurance companies. I have experienced the health care system (as a patient) in 4 different countries and I have seen many of the strengths and weaknesses of them. Health care access is a passion of mine and why I’m pursuing my MPH. We need to have a REAL conversation about this and our politicians refuse to. I hate it with a bitter passion.</p>
<p>To be honest, I was not expecting all these serious discussions on this thread. </p>
<p>Different people have different set of priorities in their life. Some will work under they drop to earn more $$. Some just wants a simple life. If the house and car are paid for, have enough $$ to last you to 65 when SS and/or other pensions kick in, why work 60 hours a week.</p>
<p>before ACA, one will have to work because they have to have medical insurance. From 2014, one could now seriously consider retiring. </p>
<p>BTW, let’s do a survey. If you submitted all the paper works such as FAFSA and CSS profile with actual data. A school gives your child a $40,000/year need based aid based on those filings. How many people will raise their hand and say “thanks, but we only need $20,000”?</p>
<p>Get some sleep, romani! Don’t lose out on precious sleep conversing with the likes of us. We’ll see you later.</p>
<p>“As many of you know, I am for universal health care. I just don’t think that’s our only problem or that it’s the solution to all of our problems.”</p>
<p>In places like Flint (even if your numbers were a bit off, the statistics are still awful), I honestly wonder if the major solution to many problems is to convince young women not to have babies, unless they are married, and can afford to take care of them. Whether by bribing them, coercing them, preaching to them, whatever works.</p>
<p>Lol, bd, I’m up writing an admissions essay… about health care access! I’m coming back here because it gets the ideas flowing :p. Otherwise, I’ve written so many of these that I’m just at a total block. </p>
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<p>OH ABSOLUTELY! The problem is that these are the places where women just frankly, don’t know about contraception. I think I’ve mentioned before on here that sex education is now part of the basic program at the DV shelter that I work at in Lansing because SO MANY of these women have no idea how to access contraception. These are districts that often have abstinence only education and I’ve had many, many women who were absolutely convinced that you could only get condoms at the doctors. It’s hard for people to believe who haven’t worked with women like this, but it’s the truth. I grew up in a low income area and even I couldn’t have imagined before working here that women could be that oblivious about contraception in the US, but it is what it is. And it’s sad, and it’s sickening. </p>
<p>And, at the same time, we’re slashing funds to educate people about their options. It’s such a problem that we’re just kind of ignoring. It blows my mind.</p>
<p>I’m all for bribing them if need be. Still cheaper than the alternative.</p>
<p>^^I’m all for knocking at the doors with free condoms. My kids even had them in their high school bathrooms (though very few people at the school even dated much). Whatever it takes, in addition to educating people, handing it out to them. Putting them in gumball machines, OB/GYN visiting your house…anything.</p>
<p>Maybe you can take some of your earlier essays and just rearrange them a bit. They don’t all have to be different, do they? Or are the questions completely different? I say, if you have one good essay, you can turn it into 20 other great essays. Unless of course, it’s for the same school :(</p>
<p>My daughter has 20/10 vision. I think it is cool. </p>
<p>DadII, I have no problem with what you are doing. Life is short. In the end, spend your life the you want. </p>
<p>I find this thread interesting. I am glad you started it.</p>
<p>“before ACA, one will have to work because they have to have medical insurance. From 2014, one could now seriously consider retiring.”</p>
<p>I think the above is a huge positive.</p>
<p>I retired early. I feel really good.</p>
<p>Even when they have access, they might not know how to use it. I used to volunteer as an escort at clinic 25 years ago, and got to know the nurses well. We all wished we didn’t have to be there - not just because we wished the patients could have some privacy, but because we wished the need would disappear. One of the nurses mentioned a patient she had seen more than once, and why - this patient had been prescribed birth control pills, and was careful about taking them the same time every day, yet got pregnant again fairly quickly. The pills didn’t fail - the doctor who prescribed them did. She inserted the pills every day, because that’s what you did with every other form of birth control she had ever used, and she didn’t know what “oral” meant.</p>
<p>Because of overall better nutrition among mothers, we have more pregnancies that make it to term, and then have no way to care for the babies. It’s not just the older patients who are living longer, and using more medical resources, but babies who wouldn’t have survived 50 years ago.</p>
<p>Then of course you have the whole political aspect of women’s health care. Do we teach abstinence only? Do we make birth control freely available? Do we argue that the “abortion business” is all about genocide (I’ve heard that one many times). Even if, as a country we agree to teach about birth control and sex, we still have to deal with the teenage girls, who want a baby - they want something to love, that will love them back. Some of them get pregnant on purpose - it’s not a failure of birth control. We need to deal with them too.</p>
<p>And to tie in with the OP’s original thoughts - we need to design our systems to be a safety net, and yet not to encourage abuse. There shouldn’t be an incentive to have low income, or to have babies you can’t support, or to retire early if you can’t support yourself. There shouldn’t be incentives to stay unemployed, in order to have the state pay for your education - go ahead and pay for the education, but give an additional incentive to go back to work too - don’t penalize for returning to worK!</p>
<p>We’ve got to get away from the “what’s in it for me” mentality.</p>
<p>^^Great post CTScoutmom. But I don’t know how you change that mentality. Maybe accept that is the mentality, and make sure the good things are rewarded, and the bad things aren’t. Not really sure how.</p>
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<p>I am not going to beat you up for saying this, but I think a better approach is to (partially?) pay of student loans of those doctors that are needed the most/considered most valuable by the society. I think we already do this for those who serve rural areas. </p>
<p>If we, as a society, decide that health care costs need to be lowered (through low reimbursement rates), then we should make sure that the doctors can afford being doctors and payoff their student loans provided they work appropriate number of years in that capacity. </p>
<p>However, not all eduction needs to be subsidized. There is no need to subsidize medical schools of plastic surgeons with private practices for example. There is also no need to subsidize someone who decides that they don’t want to be a doctor after completing their eduction. Or who can not pass boards. Etc, etc, etc.</p>
<p>Basically instead of subsidizing I think we should be rewarding those doctors who serve public good (however it is defined) and who are not sufficiently reimbursed/paid to be able to pay off their student loans and enjoy life like they should.</p>
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<p>Look at it from the other point of view: The police bring an unconscious person who is dressed shabbily to the ER. Should the ER staff 1) treat that person or 2) guess about his habits and medical history, and withhold treatment because of their guess?</p>
<p>There are around 20,000 medical student slots in the US. At, say, $200K per student, that’s $4 billion, spread over 4 years that’s $1 billion per year.</p>
<p>That’s chump change.</p>
<p>Make med school free for primary care doctors, and have a sliding scale for specialties based on average pay. </p>
<p>One article I read said the real problem with increasing the number of doctors is residency slots.</p>