Side note.. and borderline off topic..

I recently had a broken Fibula. I have private insurance (thanks to 30+ years in a union job, it still covers something, thanks in large part to the health care bill). I went in through the urgent care.. got matched up with an orthopedist. X-ray, spint.. followed by x-ray, cast, followed by x-ray cast removal. at which point they saw the bone had healed.. follow up visit.. I was back on my feet pretty well, though my hopes of a gymnastic career have been put on hold..(humor) first thing.. they tried to take me to x-ray..

I ask why yet another x-ray. Answer: the doctor ordered it. Asking why..
they said they would have to ask the doctor. I told them if there was not a better reason than that the insurance would pay for it, I would have to decline.
They asked the doctor, he had no reason.

So you are welcome for reducing medical waste, although a great deal of it is systemic.

But the answer is not kicking some basic level of health care for anyone that needs it to the curb is not realistic, not humane, does not serve the work force(increases disability/decreases a viable work force) and over all is a bad idea.

Bottom line is.. we have to watch our own health care. Just because things are covered do not make then necessary. Save some for the person next door.

Not off topic at all. Until our health care system reasonably compensates doctors and hospitals for general outcomes instead of individual procedures, we will never get a handle on spending.

---

Join the PACK!

Not off topic at all. Until our health care system reasonably compensates doctors and hospitals for general outcomes instead of individual procedures, we will never get a handle on spending.

Our health care system needs to stop compensating Doctors in the same way that car mechanics are paid. A procedure 12345 is supposed to take 10 minutes and the average shop rate is $x/hr so if the doctor can do it in 2.5 minutes he can bill for 4 of them and quadruple his paycheck. In fact it is the only way he can boost his pay. Now you know why care is so substandard in the USA.

---

or the doctor could, i dunno, work overtime like the rest of us schlubs

---

In a rich man's house there is no place to spit but his face.
Diogenes Of Sinope

or the doctor could, i dunno, work overtime like the rest of us schlubs

Why work harder and not smarter?


Not that I don't agree with the sentiments. In fact, today's trip to the eye doctor felt more like an sales push than genuine care about my vision.

well I'd say that it all comes down to the numbers. If they do 20 operations in an eight hour day that the "book" say should have taken 24 hours then perhaps someone is cutting corners or bilking the system.

I like to make sure that I get my moneys worth when I head to the Dr's office.

If I'm scheduled for a 15 minute exam then I better get 15 minutes of that Dr's time

---

In a rich man's house there is no place to spit but his face.
Diogenes Of Sinope

Isn't that the American Way? To find ways to get paid more for doing less. I've seen it throughout my entire career, ranging from a retail sales clerk to my travels in IT Land.

That's why government bureaucracy is so bad, and why some of us want the government to have less control. The more (poorly written) laws, the more someone only needs to meet a specific criteria to meet the requirements set by "the books", which only means more laws and/or more lawsuits to determine what the existing laws mean and don't mean, which also means less motivation for doing the best job possible.

Sure, in a perfect world we'd all want to be the best at what we do regardless of the laws designed to prevent Bad Things(tm) from happening, but most of us humans are just not built that way. There's plenty of us that just want to scrape by doing as little as we can while getting as much as we can.

well here's another lovely story of intentional inefficiency to make more money.

My mother, a diabetic, was diagnosed with a nasty autoimmune disease that attacks a layer of the skin. The disease is called Bullous Pemphigoid. The cure is time and steroids. she eventually had blisters on her feet which because she's diabetic and on Steroids quickly developed an infection. This was around July 4th.

She eventually became so weak and unable to stand from the infection and her inability to eat properly that the Paramedics took her to the hospital where the on call Podiatrist got her into surgery. After a week of recovery at the local hospital she was being moved to a "recovery" hospital across the street from the Main hospital.

This is where the fun begins. First off this so called recovery hospital is associated and owned by the main hospital. Because she's on medicare she got a nice ride in an ambulance for the 100 yard that it took to move her. This recovery hospital never mentioned that they were NOT equipped with a wound care specialist.

After about a week at this new hospital she had an appt with her new Podiatrist, which required her to be driven about 1/4 mile to the Doctors office. The Dr. was less than pleased with the care she had been given. Seeing as how the wound had actually gotten worse. She was immediately discharged from the "associated" hospital, returned to the main hospital, and had surgery again the next day to remove the infection again.

My brother for whatever reason had some extra time on his hands when she was in the main hospital. He noticed and entire wing of the Main hospital was closed. It had everything in it that a nurse and doctor could use to care for patients but was completely vacant.
Now call me crazy but it seems to me that the Hospital was making extra money and wasting tax payers and insurance companies money by transporting people across a parking lot when they could have just as easily named a wing of the hospital the "recovery" wing and been done with it.

Needless to say she is now doing very well in a non aligned recovery center that actually has a wound care specialist. She has now had 3 days of physical Therapy which tells me that she is doing very well.

---

In a rich man's house there is no place to spit but his face.
Diogenes Of Sinope

I'm sorry to hear about the care your mom has been given, and I'm pleased to hear she's doing better. I hope she continues down the path to recovery.

The sad truth that is... hospitals are not a safe place to be if you can not look out for your own well being. Of course if you could you probably would not be there to begin with...

---

Janice

my problem is the intential inefficiency that these warehouse hospitals create so that they can charge medicare again and again and again

---

In a rich man's house there is no place to spit but his face.
Diogenes Of Sinope

Well the market seems to be pricing in a credit downgrade for the USA. I guess not enough got cut in the budget to satisfy wall street. Euro style austerity awaits the USA.

---

what is odd is gold, oil and other commodities were all cheaper at the end of trading today by a large margin.

---

In a rich man's house there is no place to spit but his face.
Diogenes Of Sinope

Did the debt deal include another 2.8B?
http://seattletimes.nwsource.com/html/businesstechnology/2015824903_apusearnsfanniemae.html
Total bailout for liars loans to just Fannie $104.8B
When is the government going to put the liars in prison? Or are there simply so many liars there aren't enough cells?

---

what is odd is gold, oil and other commodities were all cheaper at the end of trading today by a large margin.

Commodities will go down in price if manufacturing is falling off, less demand by industry. As for gold then someones been selling hard since so many pundits consider gold to be a safe haven against all this world turmoil you wonder then why the selling. Perhaps with this big drop in the financial markets, that's going on, some people are having to sell gold to cover short term positions.

It looks like there was some improvement in the jobs market. Not a glowing report but it's looking better

---

In a rich man's house there is no place to spit but his face.
Diogenes Of Sinope

I for one would rather see Oil and other Big business pay it's fair share before Soc. Sec. takes a hit so in this one I believe I blame the Republicans the most. I don't really understand the whole thing so I won't take a stand quite yet...Like to hear what others with more knowledge think.

While I am no fan of either Party, insofar as the whole Social Security Issue stands, it's not actually 100% correct to blame the Republicans on that particular issue -- the other side of the aisle's hands have a lot more stains on them when it comes to Social Security. Here's a bit of quoted information on all of the changes in Social Security since the early days that I pulled up. It's all below. Personally, I have to point out that any time you have a big pool of money and a shortage of cash, people are going to try and put their hands into that pool. It's human nature. And while I'm no fan of either the Democratic or Republican party, I think we should not let political favoritism get in the way of the facts.

Franklin Roosevelt, a Democrat, introduced the Social Security (FICA) Program. He promised:

1.) That participation in the Program would be Completely voluntary.
-- It is no longer Voluntary


2.) That the participants would only have to pay 1% of the first $1,400 of their annual Incomes into the Program.
-- Now participants must pay 7.65% on the first $90,000


3.) That the money the participants elected to put into the Program would be deductible from their income for tax purposes each year.
-- It is no longer tax deductible


4.) That the money the participants put into the independent 'Trust Fund' rather than into the general operating fund, and therefore, would only be used to fund the Social Security Retirement Program, and no other Government program.
-- Under Johnson the money was moved to The General Fund and Spent


5.) That the annuity payments to the retirees would never be taxed as income.
-- Under Clinton & Gore, up to 85% of your Social Security can be Taxed

--------- --------- --------- ---------

Many people have paid into FICA for years and are now receiving a Social Security check every month -- and then finding that they are getting taxed on 85% of the money we paid to the Federal government to 'put away'.

A lot of the media is pointing fingers at the Republican Party, but the history books are pretty clear on who enacted all of this:

--------- --------- --------- ---------

Q: Which Political Party took Social Security from the
independent 'Trust Fund' and put it into the
general fund so that Congress could spend it?

A: It was Lyndon Johnson and the democratically
controlled House and Senate.

--------- --------- --------- ---------

Q: Which Political Party eliminated the income tax
deduction for Social Security (FICA) withholding?

A: The Democratic Party.

--------- --------- --------- ---------

Q: Which Political Party started taxing Social
Security annuities?

A: The Democratic Party, with Al Gore casting the
'tie-breaking' deciding vote as President of the
Senate, while he was Vice President of the US

--------- --------- --------- ---------

Q: Which Political Party decided to start
giving annuity payments to immigrants?

A: Jimmy Carter and the Democratic Party.
Immigrants moved into this country, and at age 65,
began to receive Social Security payments! The
Democratic Party gave these payments to them,
even though they never paid a dime into Social Security.

Which of course is very much what the Norquistian/Tea Party cabal running the Republicans in Congress definitely wants to see.

Euro style austerity awaits the USA.

Which of course is very much what the Norquistian/Tea Party cabal running the Republicans in Congress definitely wants to see.

In my humble opinion (but not to get up on a soapbox of any kind), what is needed is a complete overhaul of the tax code plus wide-sweeping austerity measures that result in a large, constant and ongoing Federal Budget surplus each year that will be required to be used to repay the National Debt. Once it has been fully repaid, that extra surplus each year can be taken out of circulation, so as to steadily increase the value of the US Dollar -- OR, loaned out to other nations, so as to generate additional income over time. Wouldn't it be nice to be the one issuing loans for a change, rather than constantly borrowing from others?

---

A fair sized chunk of the revenues are very much dependent on the health of the American economy. If you shrink governments enough, you will shrink the US economy and then you will need to shrink governments (federal, state and local) further - which will shrink the economy further -- you get the drift here right.

I'd love to see all sorts of entitlement reform -- INCLUDING 'rich corporation and rich people' entitlement reform.

I'd love to see the health care industry in the US go from a for profit, screw the people business to a non-profit structure like that of the other developed countries of the world -- 20% GDP for health care -- which is NOT as good as that of most developed countries -- is a travesty. Squeeze about 5% of GDP from the health care for profit industry, sink it into deficit reduction and bingo, the deficit gets smaller nicely.

---

US Credit rating Downgraded.
I told you so ...
http://setiathome.berkeley.edu/forum_thread.php?id=64799&nowrap=true#1136081

---