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2004 Election - How will it impact our profession?
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2004 Election - How will it impact our profession? - March 15, 2004 4:34:00 PM
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IN-PT
Posts: 25
Joined: March 3, 2004
From: IN
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Do you think that having a democrat or a repulican as president will make a difference for our PT profession?...or does it even matter?
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Re: 2004 Election - How will it impact our profession? - March 16, 2004 2:08:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
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I think that the democrats are going to push for "universal health care" (read: socialized medicine), which will be virtually guaranteed to reduce the income of health care providers. For proof, one need look no further than Medicare, which is a form of socialized medicine. They dictate what we can charge, they require the most paperwork, they have the most draconian limits on our provision of care, and they pay the least.
The Republicans, while not always conservative (I'm a conservative first, a Republican second), are clearly preferable relative to health care issues...in my opinion.
By the way, I realize that a number of forum participants are non-US citizens, so I want you to know that I'm not casting judgement on your country's approach to health care. I can only speak for the US, so please don't think I am speaking pejoratively toward any specific country; I'm offering my opinion about a form of health care.
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ChiroOrtho
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Re: 2004 Election - How will it impact our profession? - March 16, 2004 11:11:00 AM
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PTPLUS
Posts: 50
Joined: February 12, 2004
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I agree the Demos are always for socialized medicine, which if ever implemented will be bad for the people employed in health care and the nation as a whole. Name one program the government has that is efficient and provides a quality service (besides the Marine Corps).
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Re: 2004 Election - How will it impact our profession? - March 21, 2004 8:44:00 PM
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ptdan23
Posts: 224
Joined: November 6, 2003
From: Orlando, FL
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Does anyone really see socialized medicine in the US becoming a reality anytime soon?
Dan
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Re: 2004 Election - How will it impact our profession? - March 22, 2004 6:15:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
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It's already here, my friend, and it's called Medicare.
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ChiroOrtho
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Re: 2004 Election - How will it impact our profession? - March 22, 2004 11:02:00 AM
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mcap56
Posts: 618
Joined: October 26, 2002
From: New York, NY
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Hmmmmm.......
Medicare is terrible huh?? And what do you propose we use instead? Has the private sector done so well in providing coverage and care for americans? We actually spend more per capita than many countries with socialized care and yet our outcomes are worse.
As for other things the does so poorly, perhaps you would like to do without the following:
Air and water regulations
Food and drug administration to inspect the food supply and drug safety
Consumer product safety standards
Airline and transportation regulation
The armed services
Diplomatic services
Federal courts
The post office
Perhaps you object to your localized "socialized school system" or the socialized police force or your socialized traffic lights????
Blaming the government for everything is a national pastime. Where did anyone come up with the idea that we live in a free market economy. Every country has aspects of socialism. And for all of our talk, we seem to do a great job subsiziding particular industries and protecting others.
Perhaps social medicine would result in reduced salaries. But how do you propose we fix the current system? It's broken and can't continue. Our market system has of yet to come up with a way to control costs. Of them, Medicare has been the most effective. Don't just blame. Tell us your solution. We have already established that many of us don't like medicare. But wait.....we don't seem to like private insurers also.
The employers and companies in this country are strangeled by health care costs. Middle class families are on the brink.
mcap
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Re: 2004 Election - How will it impact our profession? - March 22, 2004 11:23:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
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mcap,
Three questions:
(1) Please, specifically and not in the abstract, define "middle class".
(2) Are you a U.S. citizen?
(3) Do you think anyone should be able to make $10,000,000 per year in salary, in any line of work?
When you answer honestly, I'll be able to respond more directly to your questions. It's time to take the ChiroOrtho truth-train ride...
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ChiroOrtho
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Re: 2004 Election - How will it impact our profession? - March 22, 2004 7:58:00 PM
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IN-PT
Posts: 25
Joined: March 3, 2004
From: IN
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To mcap,
Regarding your question of how to fix the current system. Just a note: There is a book by Paul Pilzer called The Wellness Revolution that makes some interesting points about healthcare, entreprenueral business practices, etc. A part of HIS proposed solution/prediction involves the general United States population demanding that the 80% of healthy individuals not subsidize the 20% unhealthy. He goes on to suggest HDHP's (High Deductible Health Plans) with stricter family budgeting, "preventative" medicine, proactive use of nutrients/vitamines, and so on. It initially sounds CRAZY, but I'm not so sure that the trend in the last few years (with higher medical insurance premiums, employers paying lower percentages of the premiums, and reduced coverages for services within the plans)might not be moving towards this. Time will tell.
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Re: 2004 Election - How will it impact our profession? - March 22, 2004 9:44:00 PM
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nari
Posts: 1568
Joined: November 14, 2003
From: Australia
Status: offline
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We too have Medicare in Oz, which means anyone (except third party, WC etc) can access its free benefits.
The problem is, the current conservative government, is out to destroy Medicare, slowly,so that everyone has to go privately.
Of course this impacts hugely on the lower and middle socioeconomic groups (meaning those who do not have money to throw around on health services).
We are hoping for a change of govt at the end of the year which will support Medicare and not favour the health insurance groups.
The system worked well in the past, and provided high quality care to all, at a somewhat lesser cost than supporting the private health insurance groups. Very generally speaking, multidisciplinary care in private hospitals is less than that in the public - there is not the intensive education of doctors at the private level.
In a private hospital, access to allied health professionals (PTs, OTs, social workers, psychologists) is almost non-existent.
chiroorth - no offence taken.
Nari
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 3:47:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
Status: offline
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One of my fundamental problems with socialized medicine in general, and Medicare in particular, is that (1) healthcare is rationed, (2) charges are fixed, (3) decisions regarding healthcare are ultimately made by politicians, not healthcare professionals/consumers, and (4) Medicare is horribly beaureaucratic and wasteful with "premium" dollars (read: taxes).
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ChiroOrtho
edit: had to re-spell "beaureaucratic" a few times [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]
[This message has been edited by chiroortho (edited March 23, 2004).]
[This message has been edited by chiroortho (edited March 23, 2004).]
[This message has been edited by chiroortho (edited March 23, 2004).]
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 9:05:00 AM
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mcap56
Posts: 618
Joined: October 26, 2002
From: New York, NY
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Let me respond to your questions:
1. I could pull a definition of middle class from an official source but I would say roughly between 30,000-200,000 a year works well. But don't worry about definitions. Let's look at two of my friends. One couple both do homecare. They have insurance for their child but cannot afford the premium for themselves. Another an outpatient ortho PT just left his job because they wanted him to contribute 800/month towards a family health ins. plan.
2. I am a citizen
3. I have no problem with anyone making 10,000,000 as long as it's legal and they are not a chiropractor [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]
These questions don't really relate to the issue at hand. Look at some of your contensions:
1) healthcare is rationed. Of course it's rationed. There is a virtually unlimited demand for healthcare. It has always been rationed whether by medicare or private indemnity companies or by families back before insurance was prevalent.
2. Charges are fixed. Of course they are. How do you expect to get to control double digit healthcare inflation? Medicare set's costs, private insurers do this, everyone does.
3. Medical decisions made by the government. Says who? The physician is still in charge of what happens with the patient. Medicare does not dictate exactly what must be done with every patient. However, they will not pay for every procedure if the utility is questionnable. Private insurers do this also.
4. Medicare is wasteful. While no government program is going to be free of waste, it is well established that medicare is administrated far more efficiently than private indemnity companies. Far less of each dollar spent goes to overhead.
So.....again, I ask.....if medicare is soo terrible, just what would you do for everyone 65 and over. Free manipulation? What is it that can be done about healthcare inflation that has far outpaced the consumer price index year after year??
mcap
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 9:10:00 AM
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mcap56
Posts: 618
Joined: October 26, 2002
From: New York, NY
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Hey just found this on cnn.com. The administration has been promoting the myth that the private sector is so efficient and that medicare administered though the private sector would save money......
"But the government's own projections are that private managed care plans will cost taxpayers more than traditional Medicare for the foreseeable future."
mcap
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 10:19:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
Status: offline
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mcap,
Thanks for your responses. Let me answer as simply as I can.
I do not think that the US Government should be responsible for our healthcare, education, social security, or whether or not our cars burn too much fossil fuels.
I do not want the government to be my, or anyone else's nanny.
I do believe that the private sector will do much better as a safety net, whether it's "big business" (as so pejoratively stated, ironically, by those employed by "big businesses") or charity organizations, e.g. church or community organizations.
This is a basic philosophical difference in our beliefs as to what our government should and should not do. I am a conservative, and a Republican, in that order. I do not like for my government to force me to pay for those who chose not to prepare for themselves. I am happy to give money to charities that provide for those who cannot provide for themselves.
Again, thank you for your response. I will overlook the sarcastic elements of your post.
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ChiroOrtho
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 10:26:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
Status: offline
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By the way, mcap, using your definition of "the middle class", we should be paying for the healthcare of families making $175,000 per year?
You've got to be kidding me.
And, there are no "official" definitions of the middle class. If I'm wrong, tell me what the "official" definitions are and where to find them.
Oddly enough, the "lower class" thinks that the "middle class" should pay more taxes and provide more services, because the "middle class" really "doesn't need that much money" Really...does a family really "need" $200,000 per year? Do you agree or disagree?
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ChiroOrtho
[This message has been edited by chiroortho (edited March 23, 2004).]
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 11:47:00 AM
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mcap56
Posts: 618
Joined: October 26, 2002
From: New York, NY
Status: offline
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First, just what does the definition of middle class have to do with this???? I never stated anyone should have to pay anyone who makes any amount. That is a separate arguement. The point is that many middle income people (making well below 100,000/yr) are having a lot of trouble with health insurance and medical costs. The two examples I cited are both solidly middle class. Both families make about 75,000 yr (max). If you are unaware of this, I can't help you. All you need to do is look around.
Second, please answer my questions.
Mato....I agree that some reform is in order but it is the third rail of politics. The boomers will suck it dry. PT is certainly overutilized at times but we may be a small part of the equation and there are some who need our services depearately that don't get them. A recent article in the Times cast doubt on the need for many bypass and angioplasty procedures. Those are the kinds of things that really need a second look.
mcap
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 12:59:00 PM
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PTPLUS
Posts: 50
Joined: February 12, 2004
Status: offline
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Originally posted by mcap:
"The boomers will suck it dry."
You just defeated all your own arguments with this one statement. The baby boomers have paid in billions, possibly trillions of dollars in their respective lifetimes to Social Security/Medicare and now where is that money? Gone. The trust fund has been mismanaged to fund other goverment programs now it is up to people my age to support our parents social program as they reach retirement age? Sorry, but I can only support the decrease of all goverment, espically social programs/healthcare.
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 1:13:00 PM
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chiroortho
Posts: 655
Joined: February 18, 2004
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PTPLUS is exactly right, macp, in that all of the money that WE have paid into all of these altruistic social programs is GONE.
There is no social security trust fund. It is nothing more than a huge I.O.U.
Why do social and economic liberals continue to insist that the "wealthy" support the "middle classes"?
This is a system guaranteed to collapse in on itself. Witness the financial turmoil of other "civilized" countries with regard to their "civilized" health care systems and financial structures.
This is undeniable, mcap.
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ChiroOrtho
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 1:30:00 PM
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mcap56
Posts: 618
Joined: October 26, 2002
From: New York, NY
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Please..............at least attribute the quote to the right person. The boomers will suck it dry was a quote by mato-tom who seems to have deleted his/her post.
Second....again. I see a lot of complaints but no anwers. That's your answer to the healthcare crisis...rely on charity????
Show me where the private sector has done a good job of controling costs please. Don't just provide the usual anti-government rhetoric.
Social security and medicare are both wildly successful if you consider their original purpose. Furthermore, if you actually knew the facts perhaps you wouldn't be so quick to post.
Are either of you aware of the fact that the middle class pay a much higher percentage of their income towards SS and medicare. So do the poor. Payroll taxes stop at a certain income level. Did you even know that? The wealthy have actually gotten a great deal from the two programs. They take out far more than they put in. The wealthy aren't subsizdizing the middle class at all!!!!!
As for money and trust fund and solvency.....I don't know what you are talking about. There isn't some pool of money sitting around to be paid out. They have always been like any other program. The current tax payers subsidize the beneficiaries as it goes along.
mcap
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 2:09:00 PM
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mato_tom
Posts: 89
Joined: June 20, 2003
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i did delete a post that included reference to boomers sucking it dry.......sorry for the confusion caused...believe me, you did not want to read what i had to say, i did not want to read what i had to say.....carry on...great topic
[QUOTE]Show me where the private sector has done a good job of controling costs please. Don't just provide the usual anti-government rhetoric. [/QUOTE]
actually my delete did have an example of private insurance cutting costs.......for PT services in my area BCBS pays 14 dollars a unit for the same thing medicare pays 28 dollars a unit for.....there is a 2-3 year waiting list for clinics to get in network BCBS............and everyone wants in.
[This message has been edited by mato_tom (edited March 23, 2004).]
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Re: 2004 Election - How will it impact our profession? - March 23, 2004 7:40:00 PM
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coloradojulie
Posts: 413
Joined: November 10, 2002
From: colorado usa
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Wow, I am a Canadian...born and raised in socialized medicine...and initiated my PT career in the same. The last ten years have been spent in the US working with the US system.
First let me say, that in no other country is bipartisanism so apparent. Such a difference between Republican and Democratic thinking! It is shocking! I have to say I migrate towards the Democratic side of things...it seems to be more open minded and less open and shut.
I think both systems have their strengths and weaknesses. Socialized medicine insures coverage for all...it doesn't discriminate between bank accounts. There are definitely more inherent controls...and some justifiably so...whether we like it or not there is a lot of insurance fraud out their, and the many pay for the few who partake. Unlike the propaganda sold to americans, you are not deprived of health care under this system. It is administered more conservatively on a needs basis. MRIs are non-profit entities so every one who is "just checking" can get one. MRIs are huge income generators and are overused in my opinion. This is one example. Another example is one of my first experiences with "All Access" uncontrolled health care, when I treated a 17 year old girl who had had five knee surgeries already...for most likely PFS. This type of gross overuse would not occur in a socialized system. Conservative measures would be exhausted before such detrimental invasive proceedures were used without medical necessity or effectiveness.
The problems with socialized medicine is the ease of abuse by the consumer. Every sniffle, every ache is brought to the ER. These are the types of usage that bankrupt the system. When you have no per episode out of pocket you quickly lose the "lets wait 24 hours and see how I feel"...to "What the heck, I'm not paying for it!". Not to mention border crossing for illegal use of the system...so prevalent that the entire system had to make changes(changes in identity cards etc.) to prevent American Citizens from coming up to Canada for free healthcare!
Private insurance is problematic in many ways as well. I have less trouble collecting from Medicare than many private insurers. Stall tactics, code exclusions, etc. are but a few of the day to day issues that plague collections from private insurers. Group health plans and even individual programs for 40 and under have premium's that are alarmingly high...many affluent people can't afford to pay $1600.00 a month to insure their families...they could pay less, but have thousands of dollars in deductibles and copays and have countless riders and exclusions written into their policies.
Having been raised in a lower class family, and I believe if my definition is correct, moved up to the middle class strata...I support the need for socialized health for those who cannot put food on the table. Without socialized programs my family would not have survived and I would not have had the opportunity to do what I do today.
I am for a melding of the two systems. Defining critical need care (such as life threatening issues that often bankrupt families) vs. non-critical care (common cold, ACL tears etc) and covering privately certain conditions and socializing more critical need care. YES defining what is what would be difficult, I get that, but it is an idea. In this system if fate would have it we have a heart attack or stroke, our family livelihood and very existance is not in jeopardy...versus is I am irresponsible with my health or am a hypochondriac, I have to pay for that coverage and whatever co-pays go along with it. Just a thought.
As far a Medicare being bankrupt despite the enormouns baby boomer contribution (contribution would have far exceeded usage for those using Medicare at that time), where did the money go? I suspect the republicans know this better than anyone. And yes, we will have to pay to make up the difference, and the money pulled out of the baby boomers' account. Because when we are old, someone will do it for us.
I don't think healthcare can be a for profit business. It has inherent conflicts of interest that generally work towards depriving those who would spend dollars on their wellness that would otherwise remain in the coffers of big business. Cutting corners in health care to increase profits is obviously dangerous.
If I could vote in the US, I would vote democratic. I think the fact that we live in a society, hopefully symbiotically, we would be a little more altruistic and give a **** about the wealthfare of our fellow man.
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