Slitherine

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ORIGINAL: pasternakski

I've always wanted to get face to face with somebody who begrudges disabled veterans the meager pittance they get so that I can kick 'im in the nuts so hard his eyes light up like a pinball machine and he goes into permanent tilt.

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ORIGINAL: 06 Maestro

Doggie

If you qualify for 900 per month from the VA, you got banged up pretty good. Years ago it was my honor to serve as a Service Officer for an American Legion post here in Nevada. You don't get very much unless you really, really deserve it.

Although I never saw any mention of it I strongly suspected you were a soldier or Marine-so now I know. I salute you and hope someday to shake your hand. If you ever make it to Las Vegas, PM me.

About the personal stalker; sort of funny, but pathetic also. It is written that a coward dies a thousand deaths. I assume that is an average amount. Perhaps with some it is twice that. Imagine the pain that those pukes must endure whenever they look themselves in the mirror. Perhaps the only time they can get their mind off of their misery is while kicking a big guy that they know won't hit them, because that is when they think they are being brave.

A happy and prosperous new year to all here, except the sniveling coward.

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ORIGINAL: Doggie

Allowing them to shirk responsibility for their own failures by exporting their problems to the United States only serves to perpetuate the cycle of poverty and corruption.

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ORIGINAL: Doggie

So how does a real man get a name like "Igotmilk?" I really can't give it much thought without throwing up in my mouth a little. I do remember a period when nicknames were popular in the military, but "Igotmilk"?. For some reason I just can't imagine a real hero like yourself, no doubt a highly decorated Special forces type, going around with a Nom de guerre like that.

Maybe you would like to enlighten us as to the details of your distinguished military service? Not that anymone is interested, but as long as you are writing my fictional biography, you might as well make up a few lies about your own life. So how does an Army ranger with a license to kill and a steely, studly demeanor like you have demonstrated here end up with a name like "Igotmilk"?

I'll admit I was a cowardly army aviator. Never set foot at Fort Benning. I laid around Fort Huachuca just hoping someone would think enough of me to give me a name like "Igotmilk". It was a fantasy never realized. I just wasn't man enough to volunteer for duty as a cook or supply sergeant in an infantry regiment. Sucks to be me. I don't even have the guts to create a sock puppet account and stalk people on the internet. I do have the distinction of being the only guy here with his own fan club, so that must count for something.

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Igotmilk


Location: Neverland Ranch

Webpage: www.pornking.us

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Igotmilk
Race Tauren
Class Shaman
Level 47
Guild Unguilded
Server Nathrezim
Battlegroup Reckoning

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ORIGINAL: chijohnaok

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ORIGINAL: rhondabrwn

I think it quite humorous that people are so intent on keeping "illegals" out of any health care reform option when we are all paying for their expensive Emergency Room medical care already. We should be demanding that they be included - it would save a lot of money if we could avoid the Emergency Room as their principal caregiver.

I think that we can do one better than "keeping "illegals" out of any health care reform option". How about we simply keep them out of the country, period. No illegals here to get sick, means no health care expenses or facilities needed for them.

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ORIGINAL: rhondabrwn
I'm sorry to see this thread turn into the usual free for all with personal insults being thrown about. I guess that's why we can't have a political forum on Matrix to allow serious discussion of social and political issues. Perhaps if the Administrators would just step in and DELETE all posts with personal attacks as soon as they see them instead of just locking some interesting threads while leaving those offensive posts up for anyone to view. Better to deprive them of their audience and eliminate the imperative for offended parties to rebut the insults and keep the whole furball going for another round.

I also would prefer that the discussions stayed on topic and avoided the personal insults. I respect Matrix's decision not to allow a political forum on their website, and understand the reasons why they have this policy.

I am not however in favor of Administrators deleting rmember's posts. Administrators are human, with opinions and viewpoints. I have no beef with any of the administrators here. However, having an admin being the arbiter of what is, and is not, an attack post, could potentially lead to trouble. An admin deleting some posts simply asks for the possibility (however remote) that an admin may become selective, deleting some attack posts, while leaving others. You could one day have an admin deleting posts that he disagrees with, while leaving those that he favors. It has been known to happen before.

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Another option might be a "guest worker" program, but that has it's own potential for abuse and the medical care problem remains

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ORIGINAL: JW

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ORIGINAL: Andrew Williams

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Circling back to the expanded pool of people who will be joining Medicare (and whose procedures are reimbursed by the government at less than cost), doctors and hospitals will find themselves with an ever growing number of patients for whom they are getting less than cost for each procedure. The doctors/hospitals will either have to pass on the cost to private insurance carriers, or decide not to accept Medicare patients, or simply decide to retire/get out of the business. More patients will be seeing doctors & visiting hospitals, but will find less doctors & hospitals to visit. Therefore, most patients may find themselves standing in waiting lines and waiting for surguries & procedures that they do not have to wait for now.

Please send a link to where I can get a crystal ball like yours... any tips for this weekends races?

I think he is right about that part of it. A link for some information.

http://www.usatoday.com/news/health/2009-12-23-heart29_ST_N.htm?csp=24&RM_Exclude=Juno

I know docs who are older and going to retire before all this starts hitting, and others who are not going to take medicare patients because they will lose money on them.

Medicare is a big problem in the US. It is an important service, yet it is financially unstable and is going to start running huge deficits. Adding more patients while decreasing reimbursements is not going to help things.

And remember, from earlier, I generally support a single payer system for the US. I'm on the far left side of the issue. But the cost issues will have to be addressed.

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Mayo Clinic in Arizona to Stop Treating Some Medicare Patients


By David Olmos

Dec. 31 (Bloomberg) -- The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.

More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.

Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering “the highest quality care at costs well below the national norm.” Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.

“Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”

Medicare Loss

The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.

Mayo’s hospital and four clinics in Arizona, including the Glendale facility, lost $120 million on Medicare patients last year, Yardley said. The program’s payments cover about 50 percent of the cost of treating elderly primary-care patients at the Glendale clinic, he said.

“We firmly believe that Medicare needs to be reformed,” Yardley said in a Dec. 23 e-mail. “It has been true for many years that Medicare payments no longer reflect the increasing cost of providing services for patients.”

Mayo will assess the financial effect of the decision in Glendale to drop Medicare patients “to see if it could have implications beyond Arizona,” he said.

Nationwide, doctors made about 20 percent less for treating Medicare patients than they did caring for privately insured patients in 2007, a payment gap that has remained stable during the last decade, according to a March report by the Medicare Payment Advisory Commission, a panel that advises Congress on Medicare issues. Congress last week postponed for two months a 21.5 percent cut in Medicare reimbursements for doctors.

National Participation

Medicare covered an estimated 45 million Americans at the end of 2008, according to the Centers for Medicare & Medicaid Services, the agency in charge of the programs. While 92 percent of U.S. family doctors participate in Medicare, only 73 percent of those are accepting new patients under the program, said Heim of the national physicians’ group, citing surveys by the Leawood, Kansas-based organization.

Greater access to primary care is a goal of the broad overhaul supported by Obama that would provide health insurance to about 31 million more Americans. More family doctors are needed to help reduce medical costs by encouraging prevention and early treatment, Obama said in a June 15 speech to the American Medical Association meeting in Chicago.

Reid Cherlin, a White House spokesman for health care, declined comment on Mayo’s decision to drop Medicare primary care patients at its Glendale clinic.

Medicare Costs

Mayo’s Medicare losses in Arizona may be worse than typical for doctors across the U.S., Heim said. Physician costs vary depending on business expenses such as office rent and payroll. “It is very common that we hear that Medicare is below costs or barely covering costs,” Heim said.

Mayo will continue to accept Medicare as payment for laboratory services and specialist care such as cardiology and neurology, Yardley said.

Robert Berenson, a fellow at the Urban Institute’s Health Policy Center in Washington, D.C., said physicians’ claims of inadequate reimbursement are overstated. Rather, the program faces a lack of medical providers because not enough new doctors are becoming family doctors, internists and pediatricians who oversee patients’ primary care.

“Some primary care doctors don’t have to see Medicare patients because there is an unlimited demand for their services,” Berenson said. When patients with private insurance can be treated at 50 percent to 100 percent higher fees, “then Medicare does indeed look like a poor payer,” he said.

Annual Costs

A Medicare patient who chooses to stay at Mayo’s Glendale clinic will pay about $1,500 a year for an annual physical and three other doctor visits, according to an October letter from the facility. Each patient also will be assessed a $250 annual administrative fee, according to the letter. Medicare patients at the Glendale clinic won’t be allowed to switch to a primary care doctor at another Mayo facility.

A few hundred of the clinic’s Medicare patients have decided to pay cash to continue seeing their primary care doctors, Yardley said. Mayo is helping other patients find new physicians who will accept Medicare.

“We’ve had many patients call us and express their unhappiness,” he said. “It’s not been a pleasant experience.”

Mayo’s decision may herald similar moves by other Phoenix- area doctors who cite inadequate Medicare fees as a reason to curtail treatment of the elderly, said John Rivers, chief executive of the Phoenix-based Arizona Hospital and Healthcare Association.

“We’ve got doctors who are saying we are not going to deal with Medicare patients in the hospital” because they consider the fees too low, Rivers said. “Or they are saying we are not going to take new ones in our practice.”

To contact the reporter on this story: David Olmos in San Francisco at dolmos@bloomberg.net

Last Updated: December 31, 2009 00:01 EST

Feel free to drop by and chat about whatever is on your mind.

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ORIGINAL: Doggie

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Another option might be a "guest worker" program, but that has it's own potential for abuse and the medical care problem remains

You are old enough to know that's the way it used to be? Seasonal guest workers used to be issued work visas which allowed them to work in the United States. These visas were typically issued to migrant farm workers. They were allowed to work on farms during the harvest season after which they returned to Mexico. They had access to the same medical care as everyone else. As the employers (usually farmers) typically provided them with room and board, they were able to take most of their wages home. Migrant farm workers living in Mexico made enough working for 3 or 4 months to live year round in Mexico.

Immigration laws were enforceable. Central American guest workers were required to obtain a passport and work visa with a yearly expiration date. That is the same thing I had to do when I worked as a civilian in Europe. Drivers had to carry an international driver's licence issued in the home country, just like Americans living in Europe and Europeans visiting the United States.

It is only when politicians began pandering to the illegal alien vote that the problem got out of hand,.

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ORIGINAL: rhondabrwn
You are quite correct in your remembrances. I'm not sure I agree with your diagnosis of why and when the system broke down i.e. politicians seeking to earn the "illegal alien vote". That seems to be a bit of a stretch. I would lean more towards employers wanting to have illegal labor to exploit with below minimum wage pay, no benefits, and poor working conditions. Then I would see the politicians looking the other way to get their campaign contributions from these employers.