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View Diary: Why Obamacare could really work, and could eventually mean larger reforms (106 comments)

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  •  Need to rein in health care costs. (2+ / 0-)
    Recommended by:
    Subterranean, blue aardvark

    That's what ACA makes no serious effort to do.  It does, presuming everything works more or less properly, provide a buffer for individuals and families against those costs by spreading them out to taxpayers, but that doesn't do anything about the drain on  the economy.

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Tue Aug 27, 2013 at 06:07:20 PM PDT

    [ Parent ]

    •  Yes it does. (1+ / 0-)
      Recommended by:
      blue aardvark

      Reimbursement reductions are being phased in.

      Reimbursements for readmissions are being eliminated.

      Helping to build a primary care infrastructure.

      More:

      http://www.rwjf.org/...

      •  So - Cutting costs by cutting back care? (1+ / 0-)
        Recommended by:
        Subterranean

        I thought death panels were a myth.

        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

        by dinotrac on Tue Aug 27, 2013 at 07:15:15 PM PDT

        [ Parent ]

        •  Only if you think a hospital readmission (0+ / 0-)

          represents superior care.

          The idea is to keep people in until they are well enough to go home, rather than send them home, have them get seriously ill, and have to re-admit them.

          If that be death panels I want one.

          I'm on a mission! http://www.dailykos.com/comments/1233352/51142428#c520 Testing the new site rules.

          by blue aardvark on Wed Aug 28, 2013 at 07:02:26 AM PDT

          [ Parent ]

          •  Wrong, but your bureaucratic mindset is one (0+ / 0-)

            reason so many people needlessly fear more government involvement in  health care.

            More than a few studies have shown home to be a superior place to heal for many people in many situations.

            I know that I've rejected hospital care twice to recuperate at home, with the duly noted reservations of doctors and a promise to absolutely communicate any problems immediately.

            The one time in the last 40 years that I allowed myself to be admitted, I left the next morning with doctors wanting to run more tests.

            A hard no readmissions policy means that you can't take a chance on home convalescence for fear of being unable to go back to the hospital if you have a complication. That's just stupid policy. Wasteful of money, harmful to patients.

            LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

            by dinotrac on Wed Aug 28, 2013 at 07:15:22 AM PDT

            [ Parent ]

            •  Only if you think that someone getting (0+ / 0-)

              seriously ill at home means they received superior care.

              I'm on a mission! http://www.dailykos.com/comments/1233352/51142428#c520 Testing the new site rules.

              by blue aardvark on Wed Aug 28, 2013 at 07:42:29 AM PDT

              [ Parent ]

              •  I must admire your diehard refusal to incorporate (0+ / 0-)

                logic into your responses.  Is it a religious thing?

                LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                by dinotrac on Wed Aug 28, 2013 at 07:51:39 AM PDT

                [ Parent ]

                •  Yes (0+ / 0-)

                  I belong to the church of "not making disingenuous arguments and sticking to them", founded by Saint Trollbane.

                  I'm on a mission! http://www.dailykos.com/comments/1233352/51142428#c520 Testing the new site rules.

                  by blue aardvark on Wed Aug 28, 2013 at 08:03:56 AM PDT

                  [ Parent ]

                  •  I presume the "not" to be a typo. (0+ / 0-)

                    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                    by dinotrac on Wed Aug 28, 2013 at 08:12:53 AM PDT

                    [ Parent ]

                    •  Either you don't know what a re-admission is (0+ / 0-)

                      or you're being deliberately dense.

                      There is no case where a re-admission represents a better outcome.

                      I'm on a mission! http://www.dailykos.com/comments/1233352/51142428#c520 Testing the new site rules.

                      by blue aardvark on Wed Aug 28, 2013 at 08:14:18 AM PDT

                      [ Parent ]

                      •  Then maybe I don't know what it is. (0+ / 0-)

                        In this context, what is a re-admission?

                        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                        by dinotrac on Wed Aug 28, 2013 at 08:46:05 AM PDT

                        [ Parent ]

                        •  Re-admission is when someone is already (0+ / 0-)

                          hospitalized, is sent home, and becomes seriously ill, requiring re-admission.

                          It's that "becomes seriously ill" part that I think you were missing. If you got seriously ill at home, it wasn't a good idea to send you there.

                          There are lots of things that can be done better (or at least cheaper) at home. But hospitals trying to cut costs send people home too soon, resulting in re-admission.

                          I'm on a mission! http://www.dailykos.com/comments/1233352/51142428#c520 Testing the new site rules.

                          by blue aardvark on Wed Aug 28, 2013 at 08:55:20 AM PDT

                          [ Parent ]

                          •  The problem with that is using a bright line (1+ / 0-)
                            Recommended by:
                            blue aardvark

                            approach.

                            It seems that you are always in danger of becoming seriously ill when you are in a weakened state, which tends to be the case when you are hospitalized.

                            Patients should not be released recklessly, of course.  That is a false economy and a danger to patients.  Neither should they be forced to stay against their will.

                            It's easy to focus on readmissions and ignore things like MRSA infections, which you are far less likely to pick up at home than  in a hospital.  

                            Re-admissions probably should raise a flag and cause questions to be asked. Beyond that, it should be case by case.

                            LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                            by dinotrac on Wed Aug 28, 2013 at 09:29:13 AM PDT

                            [ Parent ]

                          •  And I think that's what your linked study (1+ / 0-)
                            Recommended by:
                            dinotrac

                            suggests, that re-admissions aren't always a sign of poor quality care. Time was when a birth in hospital resulted in a week long stay for mother and baby. That was overkill.

                            The payment change is intended to have hospitals err on the side of caution rather than on the side of profit.

                            I'm on a mission! http://www.dailykos.com/comments/1233352/51142428#c520 Testing the new site rules.

                            by blue aardvark on Wed Aug 28, 2013 at 09:36:33 AM PDT

                            [ Parent ]

                      •  But, while I apparently don't know what it is, (0+ / 0-)

                        it seems that I am not alone:

                        http://www.sciencedaily.com/...

                        Pretty good company, so I don't feel too bad.

                        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                        by dinotrac on Wed Aug 28, 2013 at 08:47:48 AM PDT

                        [ Parent ]

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