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Too much bread, not enough butter -
And I got stuff to get back to.
..it's also possible that something else was at work: galloping elitism. Vick may not have had many advantages as a small boy, but he's had every advantage since then. From the instant he picked up a football he was over-praised, overpaid and excused by idolatry. The truth is that athletic prowess can breed a kind of coldness. We hold star athletes to be more valuable than other people -- and we literally pay them as if they are worth more than others. Roy Baumeister, scholar of social psychology at Florida State, theorizes in his book "Evil: Inside Human Violence and Cruelty," that heinous acts may not come from a lack of self-esteem but rather from egotism, a surfeit of self-regard.
This is a lovely piece of work, for no other reason it's succinct and to the point without getting too wrapped up in personal opinion (which, is arguably the point of this kind of column in the first place). But it gave me a term I could wrap a number of news items up in.
"A surfeit of self-regard."
I'd like to enhance the buzz word 'entitlement' with this statement. As is, where does it come from?
Let's consider this with regard to two of the biggest stories in health care this week:
As of Oct. 1, 2008, Medicare will no longer reimburse hospitals for the extra costs of treating injuries from eight preventable conditions. Medicare officials said they plan to add three more conditions to the no-pay list next year.
The eight conditions are patient falls, pressure ulcers, urinary tract infections, vascular-catheter-associated infections, mediastinitis, air emboli, removal of objects left in the body during surgery, and injury caused by use of incompatible blood products.
Moreover, the rule change also prohibits hospitals from billing the patients for "any charges associated with the hospital-acquired complication." *
And -
The Bush administration has adopted new standards that would make it much more difficult for states to extend health coverage to children in middle-income families, The New York Times reported on Monday.
Rushing towards socialized medicine? Not so much - because, look - these are actions taken to gut the one-payer plan we do have.
Who benefits from these changes?
Well, if Medicare doesn't pay - the patient, or the patient's insurance provider does. This does not immediately translate into more claims, per ce. But it certainly ups the ante towards your perceived need for the beast, doesn't it?
Better have that coverage! If Medicare thinks your claim is bogus because someone Oopsed - you'd better be Prepared!
Buy more insurance!
And the second one? The story itself tells the tale - "Administration officials said the changes were aimed at returning the focus to low-income children and to make sure the program did not become a substitute for private health coverage, the Times said."
You tell me.
Why does insurance have such pull?
Well, you can invest in it, like any other company. And in this case - if they make money, so do you. Simply put.
How the heck can anyone expect socialized medicine with this sort of thing in place? It's making people money. LOTS of it. Sadly, the providers don't see any benefit from this - unless they are tied to selling insurance (HMOs, largely), and balance their books against what they take in premiums vs. costs to operate.
And as long as some people can keep paying the costs of this cycle - while making that money to do it in the process - I don't see any motivation to change a thing.
We'll socialize - to a single payer plan like AT&T does telecom.
How do they sleep at night.
"A surfeit of self-regard."
I got mine - screw you.
..
I don't need to tell you how easy it is to make medical 'mistakes' with regard to pharmaceutical issues, do I?
..it's also possible that something else was at work: galloping elitism. Vick may not have had many advantages as a small boy, but he's had every advantage since then. From the instant he picked up a football he was over-praised, overpaid and excused by idolatry. The truth is that athletic prowess can breed a kind of coldness. We hold star athletes to be more valuable than other people -- and we literally pay them as if they are worth more than others. Roy Baumeister, scholar of social psychology at Florida State, theorizes in his book "Evil: Inside Human Violence and Cruelty," that heinous acts may not come from a lack of self-esteem but rather from egotism, a surfeit of self-regard.
This is a lovely piece of work, for no other reason it's succinct and to the point without getting too wrapped up in personal opinion (which, is arguably the point of this kind of column in the first place). But it gave me a term I could wrap a number of news items up in.
"A surfeit of self-regard."
I'd like to enhance the buzz word 'entitlement' with this statement. As is, where does it come from?
Let's consider this with regard to two of the biggest stories in health care this week:
As of Oct. 1, 2008, Medicare will no longer reimburse hospitals for the extra costs of treating injuries from eight preventable conditions. Medicare officials said they plan to add three more conditions to the no-pay list next year.
The eight conditions are patient falls, pressure ulcers, urinary tract infections, vascular-catheter-associated infections, mediastinitis, air emboli, removal of objects left in the body during surgery, and injury caused by use of incompatible blood products.
Moreover, the rule change also prohibits hospitals from billing the patients for "any charges associated with the hospital-acquired complication." *
And -
The Bush administration has adopted new standards that would make it much more difficult for states to extend health coverage to children in middle-income families, The New York Times reported on Monday.
Rushing towards socialized medicine? Not so much - because, look - these are actions taken to gut the one-payer plan we do have.
Who benefits from these changes?
Well, if Medicare doesn't pay - the patient, or the patient's insurance provider does. This does not immediately translate into more claims, per ce. But it certainly ups the ante towards your perceived need for the beast, doesn't it?
Better have that coverage! If Medicare thinks your claim is bogus because someone Oopsed - you'd better be Prepared!
Buy more insurance!
And the second one? The story itself tells the tale - "Administration officials said the changes were aimed at returning the focus to low-income children and to make sure the program did not become a substitute for private health coverage, the Times said."
You tell me.
Why does insurance have such pull?
Well, you can invest in it, like any other company. And in this case - if they make money, so do you. Simply put.
How the heck can anyone expect socialized medicine with this sort of thing in place? It's making people money. LOTS of it. Sadly, the providers don't see any benefit from this - unless they are tied to selling insurance (HMOs, largely), and balance their books against what they take in premiums vs. costs to operate.
And as long as some people can keep paying the costs of this cycle - while making that money to do it in the process - I don't see any motivation to change a thing.
We'll socialize - to a single payer plan like AT&T does telecom.
How do they sleep at night.
"A surfeit of self-regard."
I got mine - screw you.
..
I don't need to tell you how easy it is to make medical 'mistakes' with regard to pharmaceutical issues, do I?
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This will force hospitals to be more accountable. Why should a patient or Medicare pay for removal of a surgical sponge left by a surgeon? No, the hospital has to pay for its own mistakes.
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I'll try to tell you about billing Medicare for the ambulance trips Cliff took in the last two years of his life. Medically necessary, no other way around it, ambulance rides.
That Medicare deemed unpayable after the fact. It took settlement of the workman's comp case to get them paid. Two years after he died.
I'll try - but it's going to require alcohol to get through.
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You seem to be completely ignoring the last sentence of the snipped you yourself quoted...
I'll be the first to admit that our current medical insurance system needs a whole lot of work, but I honestly don't think this particular rule change is the sort of horror you're trying to make it out to be.
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Oh yes, they can. Oh yes, they will. Believe me.
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I'm not generally one to favor solving one's problems through legal threats, but that issue is actually the sort of thing that the legal system is supposed to be for, and would be fairly effective at.
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They held out to see if I would get a surviving spouse benefit. (Didn't get it. He lived too long past initial injury date. Like I needed that.)
Meanwhile, Cliff never saw ANY benefits from his claim whatsoever. I got set back to zero, financially - and that's all. I can't tell you what we went without, because we didn't have coverage for it up front. Grim and unfair just begins the description.
The company the ambulances worked for has since gone under. I was told everyone got paid. I don't think they got paid in time.
I got billed in the thousands. I learned to ignore it. My credit report is still reeling from the entries to all the collection agencies back in the day.
And this is nearly nine years ago now. I'd HATE to be dealing with this in today's world.
Dude. I'm telling you I need alcohol to discuss this stuff. Ask Rey how much money I had for this kind of thing. He was around.
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But it's clear that the two topics are emotionally tied together for you and bringing up one subject automatically brings up the other, and my point wasn't really important enough to go down that road over it anyway, so I apologize..
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I know what I know; I gained that knowledge in a fashion that was truly awful. The fact there are emotions involved? It keeps it from becoming an academic exercise.
Being robbed when you are able-bodied and able to defend yourself is one thing. Being tossed under the bus when you're already in a wheelchair, nearly blind and starving to death is something else.
The whole fact that your insurance carrier is going to make you fiscally responsible for any mistakes your provider made - and this could be your life we're talking about - should make anyone stop and say WHAT.
Penalties, being shut-down - those are things you can do to facilities that screw up. Hold them accountable. Like, jail. Keep the focus where it belongs. And I don't even hear "they won't be able to bill the patient." Yes, they will. They'll have to.
Making the patient the ultimate recipient of both incompetence and fiscal responsiblity is far beyond insult on top of injury.
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Hospitals account receivable clerks have no pity for the uninsured. "You wanted it fixed, you got it fixed. Now pay! You don't have the money right now? Well, sell your car/house/assets and pay us off first. No assets? Well, you're fixed up, so go to work and we'll just guarnish your wages. You're suing the hospital? That's not my problem. My problem is getting this posted before the end of the month, because if I can't, they'll hire someone else who will".
Unfortunately, one tends to have no idea the kind of pressure those clerks have on them to collect those bills unless one is put in the position of owing said bills. That's why most people don't clamor for universal health care. They're not familiar with the all around pressure that a privatized system put on everyone within it.
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The thing that gets me the most about this is that it's the patient - already victimized by a medical mistake - that is going to be holding the bag at the end of all this. And frankly, that's so wrong I won't go into it.
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I think Donna's saying this punishes the patient anyway.
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Like how we, an insured family, just got a pile of mail to do with my daughter's eye surgery from a few months ago. Surgery for which we have multiple letters from the insurer agreeing that it was "medically necessary". Turns out that "medically necessary" isn't good enough because we only joined the plan last September and the surgery was in May and it's considered "elective" in the first 12 months of being on the plan, and we started when we did because that's when my husband got his job.
So now unless we can get a letter from a doctor saying the surgery was needed to prevent death and/or permanent injury, we'll be up for more than $4000 in additional bills beyond the copays and deductibles we've already paid (almost $700). Her eye doctor said she'd write a letter saying it was "medically necessary", because it was, her eyes were glued shut with pus every morning and it was causing constant ear infections, but the eye doc won't say "death and/or permanent injury" because it wasn't quite that dire.
So the eye doctor, the surgery centre, and the anesthesiologist are all billing us directly and the insurer has sent us letters that pretty much say, "pbbbblllltttt not our problem go away or we will taunt you a second time."
Our last hope is to try to talk our pediatrician, off on maternity leave, to write the letter for us. After that, we'll have to consult an attorney, which will cost us $200 just for an initial consult, plus the increased bills from the clinics from not paying on time, plus the down-the-road costs for what non-payment will do to our currently stellar credit scores. And based on having contacted attorneys for other matters and knowing what they bill, we'd be out more in attorney expenses than we'd have to pay for the surgery itself.
So actually, it IS a potential horror when these policies come through because the system ALREADY allows for this kind of crap to happen. And it proves, as
As long as medicine is a for-profit industry, it will stay bad for patients. Profit motive ALWAYS wins. Nothing will change until it gets so bad that everyone knows directly of someone who has died far too young because of the crap. When things get as bad as they were before the New Deal (ie when kids were coming home minus fingers from working in the factories), then and only then might people be enraged enough to get off their couches and demand real change.
PS I heard about this new Medicare rule the other day on NPR and was thinking, "Oh great, more bills for Medicare patients, glad I'm not one," and then the report mentioned that apparently the Medicare insurers won't be allowed to pass the costs onto patients. Then I laughed and laughed and laughed and laughed. Pah-leeze. It'll be passed on somehow or other in the guise of rising premiums. They'll call it inflation, rising cost of care, whatever they can get away with.
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Yeah, right. Just how do you plan to enforce that, anyway? Hmmmm?
Yerks.
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Sometimes I don't know why corporations protest laws to keep them in line so much, since there's almost zero enforcement but passage of the laws keeps the people thinking that all is well. Gahhhhh.
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Back then, he wasn't even allowed in public schools. Best they had was urine testing and that never told you anything useful.
By the time I came on the scene, the damage was done - but I've been told I gave him at least ten more years due to good supportive care.
Advice? Loose any extra weight, exercise regularly and see your doctor every 90 days once you're diagnosed. That means you find someone you really REALLY love and can work with. Buy a monitor and use it regularly. *nods nods* And don't freak out overmuch.
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