Implementation Of Permanent Health Reform
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2017-04-04 08:16 by Karl Denninger
in Health Reform , 453 references Ignore this thread
Implementation Of Permanent Health Reform*
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Let's talk about the implementation of my model bill that I recently posted to reform health care on a permanent basis.

It's fairly easy to envision timelines based on complexity.  Simply put, most of this isn't complex because providers have price lists now -- you just can't see them.  So with that said, let's look at an example and assume The Bill was passed and signed somewhere around 30 September -- or the close of the fiscal year.

What's next?  The following timeline appears to be reasonable.

Beginning immediately on signature with implementation required on or before 1/1/2018:

  • CMS (Centers for Medicare and Medicaid Services; the existing federal agency) would be required to spin up the interface for Treasury to verify whether someone who presents credentials as a US citizen or lawful permanent resident is, in fact, a citizen or lawful permanent resident.  Treasury already has this via the Social Security Administration, since they have the records of all issued Social Security numbers and addresses from tax filings.  In fact you can get at this right now (for yourself) via http://ssa.gov.  CMS also already has an electronic interface system for all medical providers who are registered in order to submit Medicare or Medicaid billing; ergo, the infrastructure is already in place along with access credentials.  Medical providers who wish to avail themselves of the ability to bill Treasury for indigent patients would have to register, but the number of providers currently not registered is a tiny minority of the whole.

  • CMS begins publication of Medicare reimbursement rates for all procedures, drugs and devices.  CMS already has developed and maintains this information so this is simply a publication of existing data and can be done very quickly.  The list may be updated annually as is now the case however with Medicare being a reimbursement source but not a direct billing source as of 1/1/2019 fair notice to all non-Advantage Medicare recipients so they can start shopping providers and services is necessary. (Medicare Advantage customers will have this data from the Medicare Advantage company they select and it may well be different between different Medicare Advantage providers.)

  • Providers must put together their price lists.  They have three months to do so; failure to have and post one as of 1/1/2018 means you're closed!

On 1/1/2018:

  • Providers must post their prices and on demand honor them, along with affirmative consent requirements.  A customer may present him or herself on January 1st 2018 and request the published price.  If they do so then binding, fixed-price treatment per the price schedule and treatment consent rules in the bill must be honored.  Note that all such binding prices must include any consequential events or complications (e.g. those caused by the treatment or the facility in question.)

  • No event caused by a provider or treatment may be billed to the customer.  Alignment of the customer's interest in NOT having an MRSA infection, for example, with the provider's interest in reducing their cost must take place on an expedited basis.

  • "Most favored" nation pricing for drugs begins.  No exceptions, no apologies.  Drug prices drop like a stone.

  • Open testing begins.  If you wish to purchase a test or other diagnostic without invasive exposure beyond a blood draw and not bearing radiation or similar exposure, you may -- for cash and without a prescription or doctor's order.  Since all medical providers must have posted prices on 1/1/2018 you have a list of prices available to you and places to shop from.

  • Auxiliary services must be open.  You can buy said test wherever you want and bring the results to your doctor for consultation or treatment, without limitation.

  • A 365 day period begins during which medical providers may continue to maintain records and coding, but they must also provide human-readable records at the point of service to the consumer.  Since there is basically no medical office in the nation that doesn't have PCs or similar this is trivially done; 3 months is more than enough time to put in place the policy to provide records at the time of treatment to the consumer.

  • CMS and Treasury continue their tax processing and billing integration work with a start date of 365 days hence, or 1/1/2019.  This will be necessary to deal with EMTALA repeal and related from the bill.

  • A 180 day notification period begins during which lifestyle modification is mandatory for those with existing conditions on public medical assistance in order to receive Treasury Billing (and potential medical debt forgiveness at death due to their indigence.)  This specifically applies to Type II diabetes suffers on publicly-funded health programs, although the list of conditions will likely expand.  Those who claim that cessation of eating carbs and PUFAs are not sufficient to bring their blood glucose either under control or materially improve their condition may challenge the individual applicability to them during this time, and must prove same via isolation test (which will likely take less than 48 hours!) with them bearing the cost of the testing in cash if they lose.  Since nearly all of these people either have or should have home instrumentation (e.g. a blood glucose meter), and those who don't can certainly buy one for a few dollars at any drug store including such outlets as WalMart over the counter, they ought to have damn good evidence before attempting to claim an exemption.  These people will also know in advance, or easily be able to determine, if they're going to get caught if they try claiming an exemption and are lying.

  • A 180 day period begins during which Health Insurance companies are required to put together true insurance offerings as required under the Bill to continue selling any health-related policy with effect beyond 12/31/2018.  Since state regulators typically require some notice period (usually six months) this means they must submit same by 6/30/2018.

On 7/1/2018:

  • Medicare and Medicaid recipients with diabetes who have not made the lifestyle adjustments required are cut off from further government funded or transferred billing for their condition until and unless they make the required lifestyle change for at least six months.  They had six months warning and ability.  For the last six months of 2018 the Federal Government, during the remainder of the transition, will see approximately $200 billion in reduced spending. 20% of the adults in the United States have had their pants fall off.

  • Health insurance companies must have posted to the states their catastrophic plan pricing and coverage, along with whatever other offerings they wish to make for the 2019 calendar year.

  • All providers who intend to bill indigent customers must be registered with CMS to provide CMS with sufficient time to process any pending applications and resolve questions prior to 1/1/2019.

On 1/1/2019:

  • Level pricing and quote-before-service (and the procedures for exigent circumstances) for all customers is mandatory.

  • Centralized medical record and coding requirements end and all customers must receive their medical records at the point of service.  The AMA's monopoly on coding revenue (which, IMHO, should have resulted in them being indicted years ago) ends.

  • EMTALA repeal is effective; illegal immigrants no longer can access emergency services at the public's expense.

  • Medicaid repeal is effective at both State and Federal levels; all Medicaid spending ends.

  • Medicare Part "B" repeal is effective.  For "HMO" or "PPO" style coverage post this date Seniors can buy Medicare Advantage policies as they do now but they are not compelled to do so (as they are now.)

  • PPACA repeal is effective; all Obamacare policies, taxes and tax credits end.

  • US Code and CFR amendments to remove the PPACA, Medicaid, and Medicare Part "B" components become effective.

  • Lifestyle requirements continue.  Again, this specifically applies to Type II diabetes where a zero-cost lifestyle change simply comprised of what one eats is sufficient to reduce or eliminate drug and procedure requirements along with the degenerative effects of the condition.

  • All citizens or permanent residents who assert inability to pay a provider now have their bills submitted to Treasury for payment within 30 days.  The customer can choose any provider but the price charged must be level as for anyone else.  Providers who have more than 50% of their customers submitting invoices to Treasury on an annual dollar-billed basis are subject to audit for charges being reasonable and non-collusive (see below.)  The 60 day "no fault cure" policy begins for those who have bills submitted to Treasury due to a claim of inability to pay and tax liens begin to accrue on March 3rd, 2019.

  • For those on Medicare CMS continues to provide the payment rates it will cover to the public for Parts A and D but the customer must submit claim for payment and is responsible for the difference should the price charged be higher than the reimbursement amount.  Medicare customers thus now have an incentive to shop and no restriction on which provider they use for services.  For Medicare customers not using an "Advantage" plan Medicare Part "B" ends both as to the premium collected and benefit disbursed since Part "B" has been deleted.  For Seniors who find themselves unable to afford the portion of payment they must make even with Medicare's typical 80/20 split due to indigence they may assert that indigence just as can a former Medicaid customer and as such low-income Seniors are protected to a much greater extent than is currently the case with Medicare since they enjoy 100% access to all medical providers -- a huge increase in choice compared to today and they have access to the same billing deferral via Treasury that former Medicaid consumers have.

  • For former Medicaid consumers they may assert indigence and thus may access any medical provider as may anyone else who can pay cash.  This is a massive improvement in their access to health services over today as many providers today refuse Medicaid patients (other than via the ER!), but it comes with a tax lien that, should their economic circumstances improve in the future or should they have refundable tax credits, they will be expected to pay.  As a result former Medicaid recipients will, for the first time, have an incentive to both shop and consume medical services wisely.  Many former Medicaid consumers will choose to pay cash, especially for drugs, since a large variety of drugs will be available at monthly costs similar to that of a cup of coffee from McDonalds, but for services where they cannot afford to pay directly the safety net will be available via the Treasury.

  • Private and corporate-funded catastrophic plans, along with any new "PPO" type plans, take effect.  
    With price transparency and no billing obfuscation or "hiding" insurance costs drop like a stone.  Typical "catastrophic" coverage will be available for a few hundred dollars a year.

  • Direct and hidden billing of insurance companies of all sorts, along with "explanation of benefits" nonsense and the implied extortion attendant with same ends.  The customer is billed at a level price as with all other customers for the same good or service; whatever insurance they may have, whether it covers the service(s) provided and how much it will cover is between only the customer and the insurance company.  Collusive behavior, hidden pricing, performance of procedures without prior consent (except in exigent circumstance) and price-fixing disappears entirely.

  • For the first time in 30 years real competition breaks out in the medical field -- not just on price but also on quality of service.  With cost and outcomes exposed customers will be able to research and choose just as they choose a cellphone or automobile today.
  • Non-citizens/non-green-card holders have no right to treatment of any sort nor does any provider have liability for refusal to provide it without payment.  Non-citizens and non-green-card holders (visitors, illegal immigrants, etc) may purchase services and products for cash should they be willing and able to do so.

  • State CON laws and similar are all pre-empted.

  • Mandatory enforcement of 15 USC and the civil rights of action for individual consumers against medical providers for price-fixing, collusion and similar offenses begins.  Note that providers who collude or attempt to defraud Treasury and allegedly low-income customers claiming indigence (who really aren't) are subject to mandatory prosecution and punishment under the Bill.

And.... it's done.

The medical scam has ended.

There are no more Federal Deficits; in fact, we run a perpetual budget surplus and begin paying down the national debt.

Your standard of living starts going up every year even without a raise by about 1% each and every year instead of going down as it does today.

We no longer pay for illegal immigrant medical care at all from public funds.

You get a price that is the same as everyone else for the same good or service in the medical field just as you do at the grocery store, the gas station and the local restaurant.  The outrageous price discrimination (sometimes as much as 10, 20 or even 100x or more) served up on some people -- discrimination that usually bankrupts the consumer in question -- ends permanently.

You know exactly how much you will be billed for a medical procedure, drug or device before you choose to undergo that procedure or accept the treatment.  Your insurance company, if you have one, will have to make available what they will pay and the hospital, doctor or pharmacist must tell you what they will charge.  You will thus know what the total cost to you will be -- before you sign a consent form or have a procedure done.

If you get an infection from a hospital you cannot be billed for the drugs and time to treat that which they gave you due to their incompetence.  That risk and cost is finally on them, which will drive innovation and greater care to prevent such infections that harm and even kill Americans today.

If you can't pay you will still be treated and can still choose your doctor, but you will be responsible to cover the (much more-reasonable) bill if you become able to pay it in the future.  This will permanently put an end to the practice of poor people using the ER like a doctor's office since this sort of abuse will no longer be advantageous compared against going to a regular physician.

Drug prices fall in the United States by at least half (and more likely by 80% or more on an average basis) and for those with chronic diseases that have been sucking down drugs and procedures while refusing to make simple, zero-cost lifestyle changes they finally have a strong incentive to both do so and have their health improve materially at the same time.

There will be no more $300,000 snake bites, $150,000 scorpion stings and $1,000-per-stitch fees that get lumped on you without any way to prevent them when something bad and random happens.  Any medical provider who tries it will find their bill void and they will be prosecuted for fraud.

Obesity and diabetes incidence falls dramatically since it is now strongly in everyone's best interest to practice simple changes in their lifestyle.  An epidemic has broken out -- of people having their pants fall off.  It's a good epidemic and America is noted and lauded as being the first nation to have reversed the increasing rate of obesity and Type II diabetes.

The nation becomes far more productive as the cost of employing someone drops by a solid 15% and America becomes the place to put a multi-national business.  In short labor expense drops tremendously and productivity soars.

If you're not a currently-overpaid administrator you get a raise; for a typical median family it will be about 10% immediately as your employer's cost of having you on staff will drop by at least that amount.  For the average family of four you will see, net of your medical expenses, roughly $7,000 richer in cash spending power after tax each and every year.

Those who are currently-overpaid administrators in health care will find jobs in other sectors.  It may take a while but it will happen, as the economy comes roaring back with the newfound efficiency and productivity improvement from deleting the fraud currently consuming almost one dollar in five.

State and local pensions and budgets stabilize and, over time, taxes come down at the state and local level as the levies put in place to try to stay ahead of the pension destruction are no longer necessary.  Specifically, property taxes decrease materially which will cause both the cost of owning a house and rents to decline.

Your car insurance gets cheaper as your liability policy, much of which covers medical expenses coming from accidents where you are at fault, along with uninsured motorist coverage, will decrease dramatically in cost.

Federal Spending will contract to something similar to this -- and I note that this chart presents a pessimistic estimate. We would almost-certainly do better than what is depicted here and, I remind you, both Seniors and indigent citizens would receive better care and more choice than they have now.

And we prevent this -- our federal debt -- from blowing up in our face as the CBO currently predicts -- an event that, if it occurs, will destroy the nation just a few years from now.

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Marquiri
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Thank you for this Karl. I finally got my long awaited response from Congressman Posey. It was laughable. I wrote back, directing him to your model legislation, and copying and pasting the text in case his staff doesn't want to click the link. If there is anyone else you think would be receptive, let me know and I'd be happy to help get the message out.
Trinityalpsgal
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Incept: 2017-03-30

Weaverville, CA
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Thank you Karl.

I note that the timeline is fast-paced. (As it should be as there is no time to waste). However this will be another "opportunity point" (or obstacle, depends how you see it)that some may use to discredit/disable the Plan. You have already made a great case for what is at stake.

Imagine getting the Country to rally around fixing this beast ourselves! The act of DOING something truly meaningful and useful for All - as Healthcare impacts everyone of us - could change lives.

This opportunity could be the beginning/foundation of a NEW political Party. Implementing PERNAMENT Healthcare PROTECTION would provide a Roadmap to what is POSSIBLE; people would see results in their favor, be engaged and inspired to create more.
Tickerguy
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It's not THAT fast-paced. And there's a one-year period during which the enacted law proves itself. During that year the changes are NOT irreversible as the existing insurance system remains (as does the coding, etc.)

That one year period is in fact critical; it's the time period where the public gets to "taste" competition in the health field and what it means to their wallet.

I'm willing to make a prediction -- there won't be 10% of the population that wants to keep the old system one year into the new one, and any politician that tries to stop it at that point is going to find themselves swinging from a bridge. Leading the charge to NOT put it back will be those currently on Medicare AND Medicaid; both populations will have witnessed and experienced EXTREME improvements in access to health providers and service.

In addition half or better of those who are obese and diabetic will not only have had their diabetes disappear their pants will have fallen off as well.

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Winding it down.

Trinityalpsgal
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Actually it is a fast-paced rollout. And that feature gives it power.





Vernonb
Posts: 1759
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East of Sheol
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Quote:
Lifestyle requirements continue. Again, this specifically applies to Type II diabetes where a zero-cost lifestyle change simply comprised of what one eats is sufficient to reduce or eliminate drug and procedure requirements along with the degenerative effects of the condition.

What I really like about this plan is how it is "self-correcting". Best to get out of junk food stocks (snacks, breakfast cereals, pop tarts, etc.) while one still can. One can't eat this stuff constantly and then hope to make a real lifestyle change to make into this plan. smiley That in itself should begin to curb the obesity epidemic in this country - especially among kids.

When parents see junior's problems is now squarely on their own shoulders maybe they will begin to act at like REAL parents since they are now footing the bill.

I also like the ability to deny service - like any other business. It gets rid of the excuses regarding non-payment for those that had no intent to pay to start. No one's time and resources are truly free.


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"Mass intelligence does not mean intelligent masses."
Bigj
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What do I need to do to view older Archived Tickers? They say they're not available?
Tickerguy
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There is no means by which to get at expired articles that are not marked exempt. Non-exempt articles roll off after one month.

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Winding it down.

Bigj
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Colorado Springs
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Bummer - Thanks for the quick reply.
Capcon
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Tulsa
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How would the obese / diabetic person prove they have legitimately tried a hflc diet change and it did not work for them personally, and what governing body would be required to make a final determination of the validity of said proof?

What parameters or guidelines would be used for determining indigence at pos, as it pertains to medical bill reimbursement?

What companion mechanism could be put in place to prevent the current rationing of healthcare professional training slots at the university level? I see a potential for this rationing to be further abused to prevent medical providers from seeing wage deflation as price transparency increases.


Gmh
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Quote:
A 180 day notification period begins during which lifestyle modification is mandatory for those with existing conditions on public medical assistance in order to receive Treasury Billing (and potential medical debt forgiveness at death due to their indigence.) This specifically applies to Type II diabetes suffers on publicly-funded health programs, although the list of conditions will likely expand. Those who claim that cessation of eating carbs and PUFAs are not sufficient to bring their blood glucose either under control or materially improve their condition may challenge the individual applicability to them during this time, and must prove same via isolation test (which will likely take less than 48 hours!) with them bearing the cost of the testing in cash if they lose. Since nearly all of these people either have or should have home instrumentation (e.g. a blood glucose meter), and those who don't can certainly buy one for a few dollars at any drug store including such outlets as WalMart over the counter, they ought to have damn good evidence before attempting to claim an exemption. These people will also know in advance, or easily be able to determine, if they're going to get caught if they try claiming an exemption and are lying.


Quote:
Medicare and Medicaid recipients with diabetes who have not made the lifestyle adjustments required are cut off from further government funded or transferred billing for their condition until and unless they make the required lifestyle change for at least six months.


Karl - could you provide more detail as to how this would be monitored and enforced?
Tickerguy
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Quote:
How would the obese / diabetic person prove they have legitimately tried a hflc diet change and it did not work for them personally, and what governing body would be required to make a final determination of the validity of said proof?

Simple. If you claim it doesn't work you present yourself to an isolation ward where all you eat is HFLCMP. In 48 hours your blood sugar will likely normalize, or damn close. If it doesn't you're welcome to stay for a couple days longer -- up to 5. If you win you don't pay for the room and food (which, I remind you, is cheap since it's JUST a room, food, and finger sticks for your blood glucose.) If you LOSE you pay and are cut off.
Quote:
What parameters or guidelines would be used for determining indigence at pos, as it pertains to medical bill reimbursement?

None other than your bald claim. There's a very good reason not to lie -- if you run the bill through Treasury you're going to get hit for interest on it, and your tax refunds (including refundable credits) will be seized to pay. So if you're actually broke you can defer it, but if not you're just going to pay more -- including compounding interest. Basically anything that can return over $10k/year to you can be garnished at 100% ("windfalls"), all tax refunds and refundable credits can be seized, and all other entitlement checks (food stamps, etc) can be garnished at 25%.

There's simply no reason to put it on the Tax credit card unless you HAVE TO. But if you do the safety net is there.

Why does this safe a ****LOAD of money? Because all the middlemen are gone -- no PBMs and nothing is "free." Further, if you were on Medicaid today it's VERY HARD to get into a clinic or physicians office -- many restrict or outright refuse to see Medicaid patients and so they wind up going to the ER (at 500% of the price!) for even minor complaints. This all goes away.
Quote:
What companion mechanism could be put in place to prevent the current rationing of healthcare professional training slots at the university level? I see a potential for this rationing to be further abused to prevent medical providers from seeing wage deflation as price transparency increases.

15 USC already does this, and note the requirement for enforcement plus private rights of action.

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Tickerguy
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Quote:
Karl - could you provide more detail as to how this would be monitored and enforced?

How many times do you require reading a thing? The original post is here and while it's going to roll off soon it IS available at present: https://market-ticker.org/akcs-www?post=....

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Winding it down.
Slimtim
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Coldwater
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Karl,

Are you checking IP logs to see if any Gov peeps are reading up secretively?

:-)

-TimJ
Tickerguy
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If I am I will not tell you.... smiley

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Winding it down.
Mannfm11
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DFW, Tx
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O hate to say, but it isn't going to happen. The people in DC are too corrupt. One only need look at the false, Russians hacked the election and how much ink that is getting, that Americans would ever get the truth out of their politicians.

Trump came to DC with a promise to drain the swamp. Karl's bottom charts show close to $1 trillion a year difference. Think we are going to get enough in the corporate media that the 70% idiot population is going to give up what many fear losing to start, what they deem as FREE health care? All I can say is, dumb mother****ers.

One only look at the Ryan plan, which is only modified Obamacare and the attack on the Freedom Caucus to realize that a small piece of $1 trillion a year, buys a lot of silence. There are stories of cures of cancer and the establishment kills, destroys them or puts them in prison. We are looking at the largest organized crime syndicate on Earth. Government rarely cedes power, regardless of party. That and no other fact explains why government always puts out balls of ****, which are replaced by even larger balls of **** when the fix is put in. This is nothing but a criminal network.

I talk about this crap. Most people just accept it is expensive and someone else should pay. Modern medicine is in many senses, a scam, in the first place. They kill far more people than guns and automobiles combined, yet the industry has been given a God like image by the media. The administrators, in many cases, are endeared in many communities, when in fact they are little more than a group of organized racketeers. Don't think they comprise a significant support for the members of Congress.

There was no Russian hacking of the election. I would venture that story is more widely believed than the actual fact that Obamacare was just one more racketeering legitimizing act. No one actually got private insurance, but instead were coerced into participating in a financial******scheme. Some wish for the oasis of a one payer system. Prepare for another ass raping at the hands of the Federal Government, based, of course in the District of Criminals.

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The only function of economic forecasting is to make astrology look respectable.---John Kenneth Galbraith
Clock
Posts: 1114
Incept: 2007-09-18

South of Billings Mt
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I have read through your proposals on health care and they may or may not be accepted in part...or in full.

Karl, what you should do is run for the United States Congress...or the Senate. You have the qualifications & the ability to go toe to toe with anybody on any issue.

You owe it to yourself to give it a shot. You could also benefit the people and have a greater chance of getting your ideas implemented.

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~ Would anybody else like to see what Hillary's 'Get out of Jail' ticket looks like? ~

Tickerguy
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Not going to happen.

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Winding it down.
Steveparkermd
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Incept: 2017-03-31

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Overall this is a great plan. I like it much better than the vague one proposed by the Association of American Physicians and Surgeons, a free-market liberty-oriented group.

One aspect that gives me pause is the prospect of paying for adverse consequences of my treatment recommendations. Adverse drug reactions, for example. (As an internist, I end up treating lots of conditions with drugs in addition to lifestyle modification recommendations.)

It doesn't happen very often, but there are serious, even life-threatening, reactions to drugs that are impossible to predict on an individual basis. E.g., someone can take penicillin 10 times over the prior decade, and the 11th time, they go into anaphylactic shock and require an ambulance ride to the hospital, admission to the ICU, put on mechanical ventilation and multiple life-saving drugs. If this doesn't happen quickly enough, the patient gets brain damage and may need to be in a care facility for the rest of his life. If the patient doesn't get to the hospital in time, I pay for the funeral plus travel expenses for the relatives to come across the country to the funeral.

E.g. #2: Clostridium difficile colitis is a relatively common infection seen within 30 days of treatment by antibiotics. It's often minor and easy to treat as an outpatient. Not uncommonly, however, it requires admission to the hospital. On rare occasions it can be devastating and life-threatening. I know one patient who had to have her entire colon removed because that was the only way to cure the colitis and save her life.

If this legislation passes, individual physicians will have to figure out how to factor these risks into the prices we charge. No doubt it can be done. In the past, we've never had to do those calculations. Risk management options could include:
1) Sell my diagnostic services to the patient, noting up front that actually treating the patient may be too risky for me, so he goes elsewhere for that. "Here are your records. Good luck!" (Fifty years ago, internists were often called "diagnosticians.")
2) Obtain insurance for largely unknown (at this time) risks of consequences. I factor the cost of insurance into the price I charge the patient.
3) Join a large organization that can afford to self-insure for consequences.
4) Hope that I can simply have the patient sign a lawful waiver that would exempt me from paying for the consequences. That should save the patient money, too, unless he gambles and loses.

I could live with the new system in any case.

It still chaps my hide that Medicare pays the worst physician in town exactly as much as they pay the best. What great incentive for striving to be the best!
Tickerguy
Posts: 148437
Incept: 2007-06-26
A True American Patriot!
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Quote:
It still chaps my hide that Medicare pays the worst physician in town exactly as much as they pay the best. What great incentive for striving to be the best!

That's the reason that including complications in the cost HAS TO be done. It's the only way to resolve that problem without every single complication winding up in a lawsuit (was it the doc, or was it just random?)

If you make it part of the price then the market figures it out immediately for you. If you're better at it then the guy down the street you have fewer complications and thus the average cost is lower. Therefore so is the price you can set and make money. In a competitive market being able to do something better, faster or cheaper should result in a lower price -- and it does, until monopolies come into the game.

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Winding it down.
Aztrader
Posts: 7750
Incept: 2007-09-10

Scottsdale, AZ
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Just saw this article posted..........

http://www.businessinsider.com/tim-scott....
Trinityalpsgal
Posts: 25
Incept: 2017-03-30

Weaverville, CA
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Am convinced that the greatest resistance to implementation will come from the cartels and their protectors.

I guess things move slowly - until they don't.

The conference referenced in the link below is a perfect example of how mind-games keep potential new opportunity/views bound-up in perpetual closed loop to nowhere. Despite facts/trends/experiences in opposition.

Same could be said for how Congress (or any of the cartels) "solve problems".

My point is that the battleground for embracing and implementing Karl's Permanent Healthcare for All Plan is where the real world impacts are being lived. With the people. This means participation will come from healthcare Consumers with a "story" to tell and from Economic-minded Advocates who clearly see the financial/social consequences of not reigning in the beast.

Described as a "budding movement", cause you know we can't possibly Roundup the cartels! FEAR makes a great pesticide.

https://www.thenation.com/article/this-b....

Tickerguy
Posts: 148437
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A True American Patriot!
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It's rather interesting, actually.



That's a presentation from 2012. It was $850 billion in 2012. Last fiscal was $1.4 trillion.

Why should I continue when I've been presenting and writing for the last five years -- not one call from Congress, not one group of so-called "conservatives" willing to stand and demand that this crap stop.

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Winding it down.
Keenan
Posts: 247
Incept: 2013-01-11

Western PA
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Trinityalpsgal:

I will contact the author of that article, David Dayen. Since he's also taken on PBMs in another article ( http://prospect.org/article/hidden-monop.... ) I'll ask that he consider a follow up piece on smashing the medical monopolies, citing Karl's most recent essays.
Ckaminski
Posts: 4024
Incept: 2011-04-08

Mass-Hole!
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Karl, what you should do is run for the United States Congress...or the Senate.


And open yourself and family to the bull**** that will come along with it? Dude, you first. ****ing America doesn't want Karl. It wants bread and circuses.
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