tag:blogger.com,1999:blog-3621026.post2128119579459810230..comments2024-03-28T10:25:22.825+01:00Comments on Robert's Stochastic thoughts: ACA hospitals and doctors part MMMMMMCCCLXXXVRoberthttp://www.blogger.com/profile/14455788499385673507noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-3621026.post-74991121674148565382012-08-25T23:33:00.997+02:002012-08-25T23:33:00.997+02:00I don't get it rusty. I didn't say that t...I don't get it rusty. I didn't say that there wonìt be many unexpected consequences. I just said that one consequence expected by many (including the chief Medicare actuary) is unlikely. My clam is very narrow and in no way justifies your erroneous perception of my alleged confidence in something which I have never written.<br /><br />Of course you might be arguing that if I didn't have such confidence I wouldn't support the ACA. But the horribleness of the current system is enough to convince people who expect the unexpected and know about unknown unknowns to support the ACA.<br /><br />In any case, your comment doesn't seem to me to respond to my post. I will stop typing now because I am about to get rude.Roberthttps://www.blogger.com/profile/14455788499385673507noreply@blogger.comtag:blogger.com,1999:blog-3621026.post-60115727790601068612012-08-25T20:07:18.171+02:002012-08-25T20:07:18.171+02:00Quite a few California hospitals have no ERs; more...Quite a few California hospitals have no ERs; more every year- ERs lose money. The most recent figures that I could find are at http://www.laalmanac.com/health/he02.htm and show 121 hospitals in LA County with 75 providing some ER services in 2009 (would be fewer today)- a few have only standby which means doc on call, not a place that you should go to. I'm a public sector MD; many hospitals in the area accept Medicaid and Medicare patients as inpatients but typically discharge them without any follow up, even though they may be on a complex and dangerous drug regimen, instructing them to go to the nearest county hospital ER and demand follow up- that clogs our ER and it's often difficult for us to get comprehensive medical records from the gold coast hospital, unless we have a family member go there and make a stink- otherwise we get 6 pages of lab tests, no information as to why doctors did what they did, etc.<br /><br />The doc fix or SGR is a separate issue (and a disgraceful one going back to 1997, the Democratic 'leadership' stupidly assumed that they could come along in the next few years and fill the holes in the ACA, they didn't foresee the wild and incoherent agitation against 'Obamcare') relating more to outpatient than inpatient care. The ACA makes a partial and secretive effort to curb Medicare Advantage Programs, which are corporate welfare. SCAN agreed to pay a fine for falsifying Medicare advantage accounts in California this week. They should all be closed. Some complaints that Obama had cut Medicare come from cutting Medicare Advantage. <br /><br />The Ds lack the gonads to make a direct assault on any evil; there are many evils in our profiteering healthcare nonsystem, as long as we depend on profit making insurance companies, we will have big problems. I don’t mean that the govt must be the insurer, if insurance cos were forced to be nonprofits, as many once were, things would improve.<br /><br />resisting the machinehttps://www.blogger.com/profile/15709527439108574821noreply@blogger.comtag:blogger.com,1999:blog-3621026.post-66715797710876427702012-08-25T18:41:20.737+02:002012-08-25T18:41:20.737+02:00Robert my friend:
You have much too much confiden...Robert my friend:<br /><br />You have much too much confidence in the ability of the federal government to change a huge and incredibly complex system without triggering all sorts of unexpected consequences.save_the_rustbelthttps://www.blogger.com/profile/15292805042626368911noreply@blogger.comtag:blogger.com,1999:blog-3621026.post-36215188098683360372012-08-25T04:28:42.922+02:002012-08-25T04:28:42.922+02:00Robert:
One of the reasons hospitals accepted the...Robert:<br /><br />One of the reasons hospitals accepted the ACA was the increased in insured which were formerlly uninsured. The other reason is the growing population of elderly whio will need care. Reject both of those growing numbers and you are doomed to no growth.run75441https://www.blogger.com/profile/03790826995006015721noreply@blogger.com