Coveny’s plan for health care

Started by Coveny, October 06, 2017, 04:12:53 PM

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PopeyesPappy

Quote from: Coveny on October 13, 2017, 12:14:24 PM
You hear that because you can't hear what I'm saying over your fears and fantasies.

I'm not proposing that associate degree holding health care providers be allowed to do anything that doctors now can't do. That's a strawman fallacy.

You threw some ideas out there for making health care in the US more affordable. One of the ideas you presented was limit the awards on malpractice lawsuits to some multiple of the amount spent. I said I thought that was a terrible idea. I said the amount of a settlement in a lawsuit needs to tied to the damages done not amount spent. I also pointed out that the overall cost of malpractice accounts for less than 3% of overall healthcare costs here. You haven't said anything that convinces me you are right and I am wrong.

You also said you wanted to allow people with 2-year degrees to provide healthcare services out of their homes as a means of lowering health care costs by reducing education costs. I simply asked what kind of services these people would be allowed to provide. I didn't say they would be allowed to do things doctors can't do today. Where is the strawman there?

If you want to reduce healthcare costs by reducing the cost of the education for health care providers you do it by lowering the cost of education. Not by lowering the bar for the kind of education healthcare providers need.
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Coveny

Quote from: PopeyesPappy on October 13, 2017, 10:40:31 AM
What kind of home health care that can't legally be provided today do you propose these associate degree holding health care providers should be allowed to practice? Perscribe antibiotics? Neurosurgery? Where do you draw the line? Is there one?

It sure sounds like you are saying my position is that they will provide services not legally provided today. That is the strawman fallacy.
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PopeyesPappy

I'm asking what kind of services your home providers would be allowed to provide under your new rules that they aren't allowed by law to provide today.
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Coveny

Quote from: PopeyesPappy on October 13, 2017, 04:21:19 PM
I'm asking what kind of services your home providers would be allowed to provide under your new rules that they aren't allowed by law to provide today.

The answer is none, I'm not suggesting that they provide any services that aren't allowed by law today. Please stop with the strawman fallacies.
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Baruch

Quote from: Coveny on October 13, 2017, 04:43:48 PM
The answer is none, I'm not suggesting that they provide any services that aren't allowed by law today. Please stop with the strawman fallacies.

OK .. I am now a neurosurgeon.  I know that ancient Peruvians practiced trepanning.  I should be able to do just as much good, provided I can get my patient to chew some coca leaves ;-)
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Baruch

Quote from: PopeyesPappy on October 13, 2017, 10:40:31 AM
What I hear you saying is you want to legalize the sale of snake oil and protect the snake oil salesman from full liability from any damages that might result.

Tell me something. What kind of home health care that can't legally be provided today do you propose these associate degree holding health care providers should be allowed to practice? Perscribe antibiotics? Neurosurgery? Where do you draw the line? Is there one?

One hundred years ago, doctors weren't viewed by the public as they are today.  They were quacks getting an MD from a diploma mill.  And those were the good ones, not the patent medicine salesmen (drug pushers).  Have things really changed?  Since then, there was a massive effort to bring professionalism to the medical profession.  It was achieved.  But it isn't cost free.  If you want free, you get what you pay for.
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Baruch

#36
Quote from: Coveny on October 13, 2017, 12:14:24 PM
You hear that because you can't hear what I'm saying over your fears and fantasies.

I'm not proposing that associate degree holding health care providers be allowed to do anything that doctors now can't do. That's a strawman fallacy.

Parsing a double negative sentence.  Are you sure you didn't mean ...

"I'm not proposing that associate degree holding health care providers be allowed to do anything that doctors now [can] do."

That isn't saying much.  Home health care providers are prohibited from doing lots of things that doctors are allowed to do.  Like prescribing prescription drugs.

And I don't think you mean that ...

"I am proposing that associate degree holding health care providers be allowed to do anything that doctors now can't do."

Which means they have means beyond what doctors have.  A fantasy.

You seem to be saying ...

"I am proposing that associate degree holding health care providers be allowed to do anything that doctors now [can] do."

Which is basically calling them MDs.

PS - "until we can mass produce robots that can preform as healthcare professionals" ... fantasy.  Robots assemble doors on cars in car factories.  Patients in a clinic aren't cars being assembled.  The analogy fails.  AI is market fraud, just like "financial advisor".  The doctors aren't as much a quack as they used to be, but there are a lot of people who are just as much quack as they were 100 years ago.  Not every snake charmer got professionalized.

You want cheap medicine?  Look up a YouTube and remove your own appendix.  Conservatives are always coming up with scams that are made to look like cost savings, but are just a way of moving the crooked gravy train from one set of bastards to another set of bastards.
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

PopeyesPappy

You said

Quote from: Coveny on October 13, 2017, 09:57:14 AM
I want to make it so that someone can get a two year degree and see patients out of his home as a small business if he wants.

Insurance premiums aren't the barrier to this market you want them be. According to a 2010 survey of medical professionals the average annual liability insurance premium paid by general practitioners was less than $4000. A nurse can get liability insurance for a few hundred dollars a year. That's not a terrible liability insurance premium for any kind of small business. The medical people that pay large premiums are specialists.

The barrier to this market is people without medical degrees can't legally practice medicine. My question to you is and has been what kind of services do you expect your 2-year degree home healthcare providers to provide? The reason I want to know that is because if your 2-year degree holders aren't going to be able to do anything that they can't do today, then they aren't going to help make healthcare costs more affordable. 
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PopeyesPappy

Quote from: Baruch on October 13, 2017, 06:47:18 PM
OK .. I am now a neurosurgeon.  I know that ancient Peruvians practiced trepanning.  I should be able to do just as much good, provided I can get my patient to chew some coca leaves ;-)

Exactly...
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Baruch

#39
Quote from: PopeyesPappy on October 13, 2017, 07:11:29 PM
You said

Insurance premiums aren't the barrier to this market you want them be. According to a 2010 survey of medical professionals the average annual liability insurance premium paid by general practitioners was less than $4000. A nurse can get liability insurance for a few hundred dollars a year. That's not a terrible liability insurance premium for any kind of small business. The medical people that pay large premiums are specialists.

The barrier to this market is people without medical degrees can't legally practice medicine. My question to you is and has been what kind of services do you expect your 2-year degree home healthcare providers to provide? The reason I want to know that is because if your 2-year degree holders aren't going to be able to do anything that they can't do today, then they aren't going to help make healthcare costs more affordable.

Is Coveny = William Shakespeare?  "First lets kill all the lawyers ..."  Or maybe he is just the ultimate in consumer choice ... let the consumer choose how much medical care they get, and of what degree ... and Obama/Trump will pay for it all.  Except as pointed out, as a consumer, most patients are hopeless.  Of course, it is anti-libertarian, to prohibit non-architects to build buildings or non-engineers build bridges.  To paraphrase the new Muslim mayor of London ... "this kind of thing is the new normal" (daily terrorism).
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Baruch

Quote from: PopeyesPappy on October 13, 2017, 07:12:05 PM
Exactly...

Don't worry, I will get a second opinion from an African witch doctor, before I open your skull ...
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Coveny

Quote from: PopeyesPappy on October 13, 2017, 07:11:29 PM
You said Insurance premiums aren't the barrier to this market you want them be. According to a 2010 survey of medical professionals the average annual liability insurance premium paid by general practitioners was less than $4000. A nurse can get liability insurance for a few hundred dollars a year. That's not a terrible liability insurance premium for any kind of small business. The medical people that pay large premiums are specialists.

The barrier to this market is people without medical degrees can't legally practice medicine. My question to you is and has been what kind of services do you expect your 2-year degree home healthcare providers to provide? The reason I want to know that is because if your 2-year degree holders aren't going to be able to do anything that they can't do today, then they aren't going to help make healthcare costs more affordable.

"For example, malpractice costs in Minnesota could cost anywhere from $4,000 to $17,000 per year, depending on your specialty. But in California, a surgeon can expect to pay anywhere from $22,000 to $34,000 per year."
http://truecostofhealthcare.org/malpractice/

Another interesting site. https://www.gallaghermalpractice.com/state-resources/florida-medical-malpractice-insurance/

Also there are two other factors.
1) How are is the cost going to change if the person insured less qualified but still opened up to the same level of malpractice suit? (understand the expectation is there will be more suits)
2) This is aimed at people who have less money. Even at the minimum of $4,000 a year that's pretty steep for the 75% people who live paycheck to paycheck. https://www.cnbc.com/2017/08/24/most-americans-live-paycheck-to-paycheck.html


As far as what they "can" do. I'm open to it. My assumption is that the tier 1s will focus on the most common minor illnesses. Sinus infections, common colds, flu, etc. The course will go over not only the symptoms but major gotchas to look out for. Also as part of the system there would be medical databases where the symptoms could be entered and possible illnesses listed. Obviously with guidelines on when the patient should be escalated and how far up the chain they should be escalated. Another thing I didn't mention was that there would be two sets of tiers the general practitioner and the surgeon. Tier 1 surgeons would have a tougher time of it and only be able to do minor things like take blood, stitches, etc. As the tiers went up more complex and dangerous surgeries could be preformed. Now I'm not hard and fast on exactly what each tier can do I was only an EMT and an army field medic so I don't have enough knowledge to set those up, but getting and regulating a review board for the process or some other way to setup a governing body to regulate the tiers wouldn't be hard to do.
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Baruch

Organization only occurs within ... organizations.  National Heath Care by the Cadres of The Resistance?  I am fine with that.  I provide health care, but can't receive it, because I don't wear a uniform.  Join the Armed Forces, get heath care etc.  It also works to be a US Federal government worker.  Anyone else, you are out of luck.

This reminds me of the predictions of how efficient communism would be.  It is much more efficient to make a million left shoes all the same size, and only later do a run of a million right shoes of the same size.  If you can't wait for the other shoe to drop ;-) ... you are an enemy of the People.  Fake efficiency experts like Frederick Taylor (inventor of factory fascism).  This is where all you pay attention to is the quantity, not the quality.  You want quality, you have to pay for it.
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.

Coveny

Quote from: Baruch on October 13, 2017, 08:25:53 PM
Organization only occurs within ... organizations.  National Heath Care by the Cadres of The Resistance?  I am fine with that.  I provide health care, but can't receive it, because I don't wear a uniform.  Join the Armed Forces, get heath care etc.  It also works to be a US Federal government worker.  Anyone else, you are out of luck.

This reminds me of the predictions of how efficient communism would be.  It is much more efficient to make a million left shoes all the same size, and only later do a run of a million right shoes of the same size.  If you can't wait for the other shoe to drop ;-) ... you are an enemy of the People.  Fake efficiency experts like Frederick Taylor (inventor of factory fascism).  This is where all you pay attention to is the quantity, not the quality.  You want quality, you have to pay for it.

The sad thing is you aren't disagreeing with me, but you think you are. I'm trying to provide a mix so that there is both quantity and quality. Basically a socialist or near socialist floor that's available to everyone with a capitalist ceiling for good doctors who prove themselves and "deserve" better pay. This is the whole point of my purposed solution.
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Baruch

Quote from: Coveny on October 13, 2017, 08:40:23 PM
The sad thing is you aren't disagreeing with me, but you think you are. I'm trying to provide a mix so that there is both quantity and quality. Basically a socialist or near socialist floor that's available to everyone with a capitalist ceiling for good doctors who prove themselves and "deserve" better pay. This is the whole point of my purposed solution.

You nor I can do anything, except as the gruppenfuhrer of health in the American Reich.  Otherwise ... everyone, including doctors and patients are going to do whatever damn random thing they end up doing.  But I get you, you are an "idea" guy ...
Ha’át’íísh baa naniná?
Azee’ Å,a’ish nanídį́į́h?
Táadoo ánít’iní.
What are you doing?
Are you taking any medications?
Don't do that.