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NMpackalum

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About NMpackalum

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    Nevada

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  1. When there are term limits on Congress.
  2. Hopefully Nevada beats UCLA in the elite 8 to get into the final four and Alford gets a fat extension.
  3. NMpackalum

    Democratic Socialism - No way to pay for it

    It still baffles me that you and others don't get the concept that Medicare has no infrastructure. In a Medicare for all pie in sky plan, you don't eliminate all the parties that actually do the work and therefore are not eliminated in cost structure.
  4. NMpackalum

    Democratic Socialism - No way to pay for it

    There are a lot of oil and gas companies that transfer employees to Calgary. I see a lot of people who come back to the States after trying the Canadian system. It’s all about expectations. Canadians know what they have. Americans are dissatisfied with the inconvenience. As long as you are healthy, the Canadian system is great.
  5. NMpackalum

    Democratic Socialism - No way to pay for it

    Another Medicare/ACA jewel, tying reimbursement based on satisfaction surveys. In a zero sum game, the bottom 30 percent will get reduced reimbursements. These are ususally the county hospitals where the boutique hospitals will dump the sickest patients that have the longest stays, arguably needing higher reimbursements. The boutique hospitals can give cookies and aromatherapy to get those higher satisfaction scores. It's happening in doctors offices as well.
  6. NMpackalum

    Democratic Socialism - No way to pay for it

    Now you're getting to the point of ridiculousness. Happy is right. You're not worth engaging in a realistic conversation. 50 year old technology? The improvements in medical imaging have advanced exponentially in just the last 5 years.
  7. NMpackalum

    Democratic Socialism - No way to pay for it

    More cluelessness. I have an ultrasound in my office because the alternative for the patient is to spend 4 hours in the ER to get a 10 minute sonogram, wait another 2 hours for the radiologist to make the read and be billed $1500 for the the privilege and be discharged to call your doctor in the morning. Or she can call me for her bleeding and cramping and she can swing in for an ultrasound in an hour and I can tell her she’s not miscarrying. I’ll charge a limited ultrasound for $250, get reimbursed $120 for a net profit of $20. She goes home reassured that the pregnancy is fine instead of waiting a day or two frantic about her baby. More bullshit from you, Physician owned hospitals make up 96 of the top 100 hospitals based on CMS criteria for quality and cost. You would rather trust corporations profit motive or government efficiency over the moral hazard of physicians with a financial stake. Clearly you care about politics over results, speculation over reality.
  8. NMpackalum

    Democratic Socialism - No way to pay for it

    You really are clueless. Do you think my employees work for free? They average about $20 per hour plus health insurance, 401k match. Or that I don’t pay for insurance both health commercial and liability? Or I get free rent and utilities. Or business taxes. Or pay for supplies. Lease payments for my $125,000 ultrasound machine or my $50,000 dollar a year subscription for mandated electronic medical record system after initial capital costs. Do you really think I should work 52 weeks a year? Do you really think I get compensated for all 60+ hours per week that I work. My overhead to run my office is $50,000 per month per physician. Is there another highly educated professional where you can get a consultation for $63 dollars that you would trust? I don’t really care if people like you feel sorry for me. Most doctors know they make good money, but we work our asses off to get it. You pontificate about things you really have no clue about.
  9. NMpackalum

    Democratic Socialism - No way to pay for it

    So I get $63 from Medicare for a 99213 code which is an average office visit. Blank check, provider cost control....right.
  10. NMpackalum

    Medicare for all would... save money?

    I read the original study. They are making huge assumptions in their calculations. They are using a 4 percent administrative cost in an industry that has a 20 percent cap on costs. Considering that replacing private insurance without any government infrastructure with respect to delivering services is hardly a small number that they don't account for. Few people realize that Medicare is basically a check writer. They contract with third parties for everything from administrative services to research to delivery of care and everything in between. They have no hospitals, no doctors, no pharmacies etc... People really can't be serious about these numbers...can they? As an aside, the German system could work here if you got rid of plaintiffs attorneys or at least some type of loser pays tort reform.
  11. Generally agree. It's always difficult to get apples to apples comparison because self reporting by insurance companies, practitioners, hospitals etc are inconsistent at best. It's difficult to compare States much less countries because definitions of common conditions are often different. In this aspect at least, single payer , employed provider staff and government hospital ownership would make comparison of root cause analysis easier. Until then, it's a struggle. That said, despite the headline of the article, there isn't a place in the industrialized world where I would want to deliver a complicated pregnancy other than the US.
  12. I've read the article. Sensationalized for the masses. There are plenty of protocols in place for those conditions and are automatic when you come in to the hospital. The article conflates several conditions including preeclampsia, postpartum hemorrhage, intraoperative hemorrhage and venous thrombosis. These conditions are grilled into an obstetrician from day 1 of residency. Blues is right in that it's the reporting of complications from state to state, country to country that can be suspect. The article infers that quantifying blood loss is a good first step and again this conflates blood loss with preeclampsia. That's not to say there isn't a problem. Smltwnrckr actually is quite insightful in that the trend in obstetrics is toward a more natural, hands off approach to management of labor including use of midwives and home births which can end up with train wrecks dropped off in the hospital. Of course there are bad outcomes that are preventable and it's actually a good step that attempts at improvement in care are a priority. Just leave the sensationalization out of it.
  13. NMpackalum

    Nevada Fan Uni Poll

    It's been a couple of years since my teenagers have bought anything but adidas, which reflects the rest of their peers. It's all cyclical.
  14. NMpackalum

    Strong GDP numbers!

    Too bad 2014 only had 2.6 annual growth despite that quarter. Hopefully 2018 comes in at 3.1 or better which will exceed Obama’s best year. I’m sure we’ll get a recession during Trump’s term and you can start a thread about it. This economic cycle is due for one.
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