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Post by ken on Apr 4, 2014 12:46:30 GMT -6
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Post by Flitzerbiest on Apr 4, 2014 22:11:26 GMT -6
Hey Ken,
Actually, the "cancer centers" are a bit on the fringe of medicine. I'm not talking about the real deal rock-solid institutions like Johns Hopkins, Sloan Kettering and my employer (not that I have that I personally much to do with cancer professionally--more treating the side effects of chemo stuff), but rather the likes of Cancer Centers of America. It's not that these institutions are intentionally false or staffed by people who don't believe in what they are doing--I think they really do live up to their collective (paraphrased) mottos--"nobody is beyond hope". The concern is that, in saying that no one is beyond hope (which I would join you in saying personally if not spiritually), they tend to convey a message that isn't really grounded in fact. The (legitimate, IMO) gripe is that they have a tendency to offer ongoing, expensive (even bankrupting) treatments to statistically "hopeless" patients, burdening the lion's share of patients with crippling illegitimate expense on top of their legitimate grief. Caveat emptor, but patients in the extremis (yes, spell check--I have that word right, dammit) of healthcare crisis don't always have the wherewithal to sort these things out rationally.
Again, I don't blame most of the people who work there or ANY of the patients who go there. But, as they say, the road to hell is paved with good intentions.
Good question, or at least a non-contentious one for you and me. I wish I could say that your assertion of my expertise were justified here. Actually, no I don't. Cancer sucks.
biest
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Post by Flitzerbiest on Apr 4, 2014 22:13:41 GMT -6
BTW, I'm not going to bite on the ACA, at least today. It isn't the way I would have done healthcare as an inalienable human right, but it isn't the antichrist either. If you want to ding me this time on semi-ducking a question, I'll plead "fucking tired". Ask me again tomorrow if that part of the debate matters to you.
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Post by showmedot on Apr 5, 2014 13:57:52 GMT -6
I'm not sure why this limitation is so difficult to accept.
I once had dental insurance that listed only one dentist in network and thus 100% covered. I went to the guy once, and it was an unsettling experience. There were no qualified hygienists on staff, so I got my teeth powerbrushed and that was it when I knew I needed a bunch of scale removed. When I asked who would do the scaling, the dentist himself told me that I'd have to go to a periodontist; he didn't do scale removal and his assistant wasn't qualified.
Considering the condition and layout of this guy's office, I'm sure he was 100% covered because he was cheap, cheap, cheap.
I was astounded that this farce was the only dentist in a city of 350,000 fully covered by that insurance.
I pay extra to go to my current dentist and periodontist because neither is in network on our current insurance.
People have to look closely at what coverage they'll get before signing on with any health insurance. It's decidedly "buyer beware" whether we like it or not.
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Post by ken on Apr 5, 2014 15:11:39 GMT -6
Hey Ken, Actually, the "cancer centers" are a bit on the fringe of medicine. I'm not talking about the real deal rock-solid institutions like Johns Hopkins, Sloan Kettering and my employer (not that I have that I personally much to do with cancer professionally--more treating the side effects of chemo stuff), but rather the likes of Cancer Centers of America. It's not that these institutions are intentionally false or staffed by people who don't believe in what they are doing--I think they really do live up to their collective (paraphrased) mottos--"nobody is beyond hope". The concern is that, in saying that no one is beyond hope (which I would join you in saying personally if not spiritually), they tend to convey a message that isn't really grounded in fact. The (legitimate, IMO) gripe is that they have a tendency to offer ongoing, expensive (even bankrupting) treatments to statistically "hopeless" patients, burdening the lion's share of patients with crippling illegitimate expense on top of their legitimate grief. Caveat emptor, but patients in the extremis (yes, spell check--I have that word right, dammit) of healthcare crisis don't always have the wherewithal to sort these things out rationally. Again, I don't blame most of the people who work there or ANY of the patients who go there. But, as they say, the road to hell is paved with good intentions. Good question, or at least a non-contentious one for you and me. I wish I could say that your assertion of my expertise were justified here. Actually, no I don't. Cancer sucks. biest Thx
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Post by ken on Apr 5, 2014 15:11:55 GMT -6
BTW, I'm not going to bite on the ACA, at least today. It isn't the way I would have done healthcare as an inalienable human right, but it isn't the antichrist either. If you want to ding me this time on semi-ducking a question, I'll plead "fucking tired". Ask me again tomorrow if that part of the debate matters to you. It wasn't bait.
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Post by showmedot on Apr 5, 2014 16:14:29 GMT -6
Remembering how desperate I felt when diagnosed, I think such hopeful slogans can be dangerously deceptive, luring cancer victims and their families into thinking there's a better possibility of survival than the patient actually has.
In that regard, I still think of my best friend of 25 years who learned she had an aggressive Stage 4 breast cancer with tumors too near her heart to be safely removed. There were other metastases. Her doctors told her to enjoy each day she had as, realistically, there was nothing more they could do after the mastectomy.
She demanded and went through chemo anyway, saying doctors aren't always right and maybe it would make a difference. It didn't. Less than a year after finishing chemo, she died of a massive opportunistic infection probably invited by an already impaired immune system having been further weakened by the chemo.
I often think about her and other such I've known and hope that I will be capable of facing reality should I be in such a position eventually. Anyway, I'm determined to be as informed as I can about what is or isn't feasible in the hope that I can be as courageous as Julia Child reportedly was. When told that she had kidney failure with little possibility of improvement, she chose to refuse any but comfort care.
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Post by ken on Apr 5, 2014 17:07:24 GMT -6
Remembering how desperate I felt when diagnosed, I think such hopeful slogans can be dangerously deceptive, luring cancer victims and their families into thinking there's a better possibility of survival than the patient actually has. In that regard, I still think of my best friend of 25 years who learned she had an aggressive Stage 4 breast cancer with tumors too near her heart to be safely removed. There were other metastases. Her doctors told her to enjoy each day she had as, realistically, there was nothing more they could do after the mastectomy. She demanded and went through chemo anyway, saying doctors aren't always right and maybe it would make a difference. It didn't. Less than a year after finishing chemo, she died of a massive opportunistic infection probably invited by an already impaired immune system having been further weakened by the chemo. I often think about her and other such I've known and hope that I will be capable of facing reality should I be in such a position eventually. Anyway, I'm determined to be as informed as I can about what is or isn't feasible in the hope that I can be as courageous as Julia Child reportedly was. When told that she had kidney failure with little possibility of improvement, she chose to refuse any but comfort care. Cancer is always difficult and emotionally draining. It is always good to have close friends during difficult times as I am sure you were to those you have mentioned. Blessings....
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Post by Flitzerbiest on Apr 5, 2014 19:31:05 GMT -6
BTW, I'm not going to bite on the ACA, at least today. It isn't the way I would have done healthcare as an inalienable human right, but it isn't the antichrist either. If you want to ding me this time on semi-ducking a question, I'll plead "fucking tired". Ask me again tomorrow if that part of the debate matters to you. It wasn't bait. Ok. I just meant I didn't have the juice to look into your link. I'll try to get to it tonight once I get a meal in.
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Post by ken on Apr 10, 2014 20:06:16 GMT -6
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Post by Flitzerbiest on Apr 10, 2014 22:50:00 GMT -6
They've been running on this issue since 2008. I think they are probably starting to get some public traction, and again, I don't like the plan much compared to the alternatives, but there will be hell to pay if we simply roll back the clock.
On a lighter note, Mrs.Flitz and I filled out new living wills today. Go. Do it.
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Post by ken on May 14, 2014 15:05:29 GMT -6
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Post by Flitzerbiest on May 15, 2014 8:41:37 GMT -6
Yep, Ken. That's waste, and it's the sort of thing that is going to be harder to control given that we lacked the courage to go where we we ultimately end up, i e single payer. Iam, right now, at an international Emergency Medicine conference where it is once again crystal clear that the Canadians are kicking our ass in terms of providing scientifically validated care for less cost and with better outcomes. Why? (IMO) Because they have a comprehensive AND comprehensible system. There was howling north of the border when it implemented, but the fact of the matter is that they have a system that can be fairly easily improved, and that they have done so steadily, leaving our "best in the world" system in the dust. Two questions: 1. You can just as easily find as/more egregious examples of waste in DoD spending, and yet you have never posted any, yet you have posted several regarding the ACA. Why? 2. The American healthcare system pre-ACA left 40 million, disproportionately women, children, poor and mentally impaired without insurance. You don't like Obamacare. I get it. However, can you provide me with a morally and financially coherent argument for returning to the pre-ACA state? I'll take anyone else's answer on #2.
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Post by Jim on May 15, 2014 9:57:48 GMT -6
2. The American healthcare system pre-ACA left 40 million, disproportionately women, children, poor and mentally impaired without insurance. You don't like Obamacare. I get it. However, can you provide me with a morally and financially coherent argument for returning to the pre-ACA state? I'll take anyone else's answer on #2. Hi FB: We are never returning to a pure pre-ACA state. The immensely popular ban on coverage denials for pre-exisiting medical conditions and the extension of the age when kids get booted of of the parent's policies are here to stay. The Medicaid expansion will stick - it simply can not be rolled back without political suicide. Arguably, these will be the only significant elements of Obamacare left in a few years. Some of the more problematic stuff (the individual and corporate mandates) will be delayed infinitely because the Administration lacks the will (or has the good senses) not to implement unpopular and arguably economically detrimental policies. In the end, Obamacare will result in a potentially measurable but really quite small increase in the number of people who are insured. The cost and waste involved will not even be close to justified. The personal disruption experienced by the people will not be remotely justified. The people's confidence that the Federal Government can do anything well will be further eroded. "Substandard" insurance plans are going to be re-authorized in a year or two. Obamacare will be reduced to a few small reasonable and targeted insurance reforms that could and should have been implemented with efficient bi-partisan bills but which instead were implemented in the most costly, contentious, ridiculous manner conceivable. Jim
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Post by ken on May 15, 2014 12:32:56 GMT -6
1. You can just as easily find as/more egregious examples of waste in DoD spending, and yet you have never posted any, yet you have posted several regarding the ACA. Why? 2. The American healthcare system pre-ACA left 40 million, disproportionately women, children, poor and mentally impaired without insurance. You don't like Obamacare. I get it. However, can you provide me with a morally and financially coherent argument for returning to the pre-ACA state? I'll take anyone else's answer on #2. Jim's answer is good enough
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