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New York, 5:08 AM
Tue Nov 10
55 posts in the last 24 hours
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11/08/09
I'm happy with most of it - it's an incrementalist bill that lays the groundwork for single payer - but there's a lot I don't like. Too many things were left out, and the abortion amendment had no place in a modern society's health care structure. #healthcare
11/08/09
"Think about it. Government is the negation of freedom."
I did think about it, and he's totally right! Oh my god I'm so stoned. #healthcare
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We managed to find the funds (which are probably now in the billions) to fight two wars and really have nothing but lost lives to show for it and yet, somehow trying to get American citizens decent health care is going to bankrupt us.
There are legitimate points some of the Republicans also make about tort reform and access because you're talking about taking on an additional 20-30 million people with the same amount of facilities and providers. I know they've proposed adding to the class size in medical schools and such and I hope that won't get killed by the AMA, who was staunchly against it when Clinton proposed it during her try at fixing this.
I, for one, would have liked to see something in this bill about banning pharmaceutical companies from advertising prescription medications on the air and in print.
While the profession is a noble one, I can say from first hand experience that there is a great deal of them (physicians) who are morally corrupt...........when it comes to financially rewarding themselves at the expense of the American taxpayer.... as well as many of their patients. #healthcare
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Except for the fact that they probably won't have a GP, since we're looking at an incredible shortage of doctors once this plan goes into effect (just ask Canada or Massachusetts, where I'm from).
And let's hope that fever isn't actually something more serious that requires, say, a surgery... that kid could have to wait months to see a surgeon.
Do we need healthcare reform? Absolutely. Is this bill a step in the right direction? Absolutely not. #healthcare
11/08/09
We do have a shortage of primary care physicians, especially in rural areas. Part of this is due to the phenomenal cost of medical education in the US ($40-60k per year as opposed to $0 - $10k in most of Europe) With that kind of debt burden, students have a greater incentive to follow the money to dermatology, anesthesiology etc... rather than to stick around and offer primary care to sick kids. In short, if we want more primary care physicians, we need to address the absurd cost of medical education here in the US.
Also, GPs barely exist any more. Family Medicine is the specialty that offers the broadest primary care, Pediatrics, Internal Medicine, Ob/Gyn, and Geriatrics also do primary care and all require at least 3 years of post-graduate training (at resident wages too low to pay off a significant portion of student loans). But the sky isn't falling yet. There are a great many Nurse Practitioners are rising in the ranks to offer primary care.
I agree that our country would be best served if people could build relationships with their primary care providers. But I think the solution is actually greater government intervention to help Medical and NP students fund their education. This bill is a huge step in the right direction. I hope it'ts the first step of many. #healthcare
11/08/09
Free medical school for nurse/family practitioners if they agree to serve in underserved areas for 2 years: that's my suggestion -- like NYC offers teaching fellowships #healthcare
11/08/09
I'd like to see more tuition remission programs offered to MDs. Most of the current programs require signing a binding commitment before medical school which can be dangerous. I'd like to see more programs offering tuition assistance during and after medical school - when students can make informed decisions about going into primary care. The school may be longer but I don't think MDs are obsolete just yet.
11/08/09
11/08/09
Without tort reform, no. #healthcare
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Legislation to limit the amount of money that can be secured in a medical malpractice settlement involving a consumer or group of consumers and a health care provider. #healthcare
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I see Mass as a microcosm of what's going to happen in the US. The problem is not an actual shortage of doctors yet, the problem is that when Massachusetts extended health care to virtually all its residents, there has been a crush of people in the system, straining the current load. Speaking with family back home (I currently reside in Brooklyn, actually used to live right off the Myrtle-Willoughby stop), they're saying that lots of people are looking at 2-3 month waits to see a doctor. People are actually resorting to the "emergency room" doctor's visit because they can't get into to see a general or family practitioner. Therefore, I worry about adding 30 million+ people into our current system.
I'm not a big fan of this bill in its current form, but we really do need to see more doctors, because regardless of any outcome there are going to be more people using our healthcare system than ever before. We also need tort reform in the areas of medical malpractice, that would absolutely move to drive costs down. #healthcare
11/08/09
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11/09/09
That's an incredible amount of money. #healthcare
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11/09/09
Why protect the trial lawyer lobby? 10 billion is 10 billion. I'm not so dismissive when I look at the costs of lawyer-enriching robbery that we all subsidize. But hey, if there's one stupid cost, all of them are justified! #healthcare
11/09/09
Besides, whenever people talk about this issue, they always include those stupid, irresponsible juries. And I get a little nervous whenever anyone talks about disempowering the jury system.
So yeah, I'll be all for tort reform when doctors start minding their own house. #healthcare
11/09/09
Lawyers are introducing a large cost into the health care system that is devoid of social utility. If we're constructing a better mousetrap, that's one of the elements I'd incorporate into the design. That's a net positive for anyone but lawyers - lower costs would be a win for moderate Democrats who want to show independents that they aren't being completely blind to potential funding issues. #healthcare
11/08/09
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That said, I think the issue the pro-choice side REALLY needs to do something about is not the cost of abortions. It's access. If some woman in Alabama or Nebraska,* where all the clinics have packed up and moved after harassment and bombings, and the GYNs have been murdered and not replaced, has to drive six hours to another state to get an abortion, whether she can pay for it (or the govt does) isn't the big question.
*don't know if these are accurate examples and too lazy to look it up, but you get the idea. #healthcare
11/08/09
[www.ms4c.org] #healthcare
11/08/09
I worked at a clinic in California, and we routinely had women coming in from Utah, Nevada, and Oregon. Some of them came because the providers in their area were so overbooked that they would have to wait too many weeks to get in. Some of them came because they had waited for an appointment, and then found out they were in their second trimester and the provider they went to only did first trimester abortions.
The current provider shortage is crazy, and it only leads to more women having later term abortions.
There are various groups dedicated to getting poor women the funding and transportation needed to get an abortion.
There's one in NY, if you're interested: [www.nyaaf.org]
Also, this is the group we worked with in CA (they help women all over the country, not just in CA): [www.whrc-access.org] #healthcare
11/08/09
11/08/09
And since having coughed in third grade is now a pre-exisiting condition, we need "someone" to tell the IN-surance companies to do their fucking job and insure people. #healthcare
11/08/09
Most pediatricians I know either accept Medicaid, would have tried to work something out for an existing patient (including seeing them for free - especially in an emergency), or would have accepted the equivalent of the insurance payment (generally around $60) in cash if the patient could afford it. Holla' if you need the names of some good practitioners in NYC who take Medicaid. #healthcare
11/08/09
11/08/09
Abortions aren't that expensive, people. We're talking about a cost of $300-$500, or $400 for the RU-486 pill. Doubtfully more than $1,000 at any given location. This is not a case of some $10,000 procedure that, if it were not covered, there would be a rash of impoverished women forced into having babies they did not want. I have private insurance that does not cover abortions, and I suspect many of you do as well. And I never in a million years thought abortion would be covered in some kind of public-option health care initiative. Never. Did you really think that was going to happen?
Anyway, this isn't about me you say, this is about all the poor/impoverished women who won't have access to abortions because they can't afford the fee at Planned Parenthood (who, by the way, would work with any one who came in looking for an abortion and couldn't afford it at the time to finance the procedure). But those women, on the whole I am educated-guessing, don't have access to those procedures NOW, because they don't have insurance or their insurance does not cover abortions (Medicaid is run by states, and in some states it covers abortion, and some not). And yet, these women remain savvy enough to figure out a way to pay or organize a payment plan to get one. Hm. I suppose most women can do the very simple mental calculation that, particularly if finances are difficult, raising a child is more expensive than terminating a pregnancy. A difficult choice, of course, but once that calculation is made and decided upon, gathering together the more modest funds for an abortion might not seem like such a daunting task.
Throwing women under the bus? I've seen this phrase bounded about since the House bill passed. But no way. If it passes and is signed, and fulfills its intent, it will offer prenatal care, birth control, gynecology, other health programs, to millions of women who had zero access to those things before. The only thing it limits is one procedure. I can live with that. I think it's kind of lazy to start screaming that we were denied our state sponsored abortions when a.) such a thing doesn't exist now, b.) there is so much more good that access to health care can do for women (well, I can't get that $500 abortion, but now I can treat my breast cancer without worrying about going bankrupt) and, c.) You KNEW there was no way in hell this plan would ever have covered abortions, and trying to argue that you are surprised by this is just ... God. #healthcare
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But it's still infuriating that the screaming right-wing assholes get to dictate anything about all American women's health policies. If people are upset by this it's because of the larger political picture, not so much because of the specifics of the procedure and its cost. #healthcare
11/08/09
11/08/09
The Dems in swing states that think their pushing for these exclusions will make them popular with said nutters are a bit touched in the head themselves.
That said, if it was enough to get it passed, then Reconciliation, or taking a second bite later, is better than letting the whole thing die on the vine. #healthcare
11/08/09
I'll just add this: abortions have always been available to women with money. Abortions will always be available to women with money. Which is what is so ridiculous about this silly amendment. It's basically saying: fuck you poors!
But yeah, it made the final passage possible, so okay.
Planned Parenthood will be getting a few extra bucks from me now. I keep upping my yearly donation whenever something like this happens. #healthcare
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11/08/09
This Bill will never get through the Senate in its present form, so for it to pass in the Senate it will undergo yet another metamorphosis. Then, assuming it gets through --- and I am assuming no such thing -- it goes to Conference where it may emerge, once again, unrecognizable, or die a slow death until next year. #healthcare
11/08/09
[tools.advomatic.com] #healthcare
11/08/09
Here I stand
brick in hand
free abortion on demand! #healthcare
11/08/09
Meanwhile, they have you have squabbling over abortion rights and boner pills.
Wake up America.
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Both entities work very well, in my opinion, as does the VA in providing health care to veterans and the Medicare system in subsidizing health insurance for the elderly. #healthcare
11/08/09
@SwimJamie83: Why not send an angry letter to your senator with one of these?
11/08/09
This is the best thing you've ever written, Foster. And you are a good writer.
Observe the timestamp and note that I am clearly drunk. But it is still quite good and sad and small and true, this thing you wrote.
It's funny to be sick of a country that is so very sick. #healthcare
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