Rationing of heartbeats by Medicare

BenBurch · 10th August 2009, 06:00 PM

I know that "everybody" (in the conservative echo chamber) says that government medical care is going to ration care and kill off the old people.

Well. It appears to be true.

I am listening to a woman on the radio who has been denied a pacemaker battery replacement by Medicare. Her battery is run down. But due to a new medicare rule, they have to run the battery down far past the safe level now, turning off features of the pacemaker, limiting beats to 45 bpm, and shortening the office visit interval in stages down to where the patient has to go in every two weeks and they allow the pacemaker to skip up to 20 beats per minute before increasing its voltage!

This is it; government medical rationing of HEARTBEATS.

The kicker?

The rule took effect on January 1st, 2009, and was a product of the BUSH ADMINISTRATION.

I will post some audio from this later tonight, and I am going to try to get this woman to write her story.

-Ben Burch

DC · 10th August 2009, 06:13 PM

Rolfe · 10th August 2009, 06:31 PM

Aw come on. That sounds as big a pile of poo as the worst exaggerations and lies the right-wingers have published about the NHS.

Rolfe.

kellyb · 10th August 2009, 06:39 PM

Originally Posted by Rolfe

Aw come on. That sounds as big a pile of poo as the worst exaggerations and lies the right-wingers have published about the NHS.

Rolfe.

Medicare really is pretty bad right now. They hire private insurance companies to administrate various things (that's where a lot of the money paid to Medicare goes), so, I'm not needing to suspend disbelief for this one.

It's our entire system that needs to be revamped from the ground up, medicare included. The Obama admin has already started making improvements by upping the pay to PCPs at the expense of the top-paid sub-specialists.

Here's an interesting blog entry on the matter:

http://covertrationingblog.com/gener...nts-never-mind

Dude's a bit of a conspiracy theorist, but, these are strange times, so...

Rolfe · 10th August 2009, 06:54 PM

My God, you're system is even more broke than I imagined. And the comments are even more depressing. One person thinks other countries will have to do the same, and the person who replies says that universal healthcare just limits access full stop.

The article is essentially saying that Medicare won't reimburse hospitals for events it considers to be avoidable errors in hospital care. Meaning they should swallow the costs, and obviously it's intended as an incentive to stop these things happening.

Of course that couldn't happen in the NHS, because the NHS doesn't bill the NHS for looking after patients!

The article is pointing out the law of unintended consequences might dictate that in fact doctors will be reluctant to recommend an elective procedure in a vulnerable elderly patient, for fear one of these things happens and costs the hospital a lot of money. Which certainly sounds possible.

The entire US system seems, to an outsider, to be completely heartless.

Rolfe.

BenBurch · 10th August 2009, 07:04 PM

Originally Posted by Rolfe

Aw come on. That sounds as big a pile of poo as the worst exaggerations and lies the right-wingers have published about the NHS.

Rolfe.

Show archive posting is in 20 minutes. I will post a link here and you can listen for yourself. She did not sound like she was lying to me!

FlamingMoe · 10th August 2009, 07:05 PM

Originally Posted by BenBurch

This is it; government medical rationing of HEARTBEATS.

The kicker?

The rule took effect on January 1st, 2009, and was a product of the BUSH ADMINISTRATION.

How is this "the kicker"? Medicare is expensive and costs need to be cut. This is true across all administrations.

BenBurch · 10th August 2009, 07:08 PM

Originally Posted by FlamingMoe

How is this "the kicker"? Medicare is expensive and costs need to be cut. This is true across all administrations.

If you can't see the problem with that, no matter who does it, I can't help you.

BenBurch · 10th August 2009, 07:59 PM

http://www.whiterosesociety.org/cont...0-08-2009).mp3

kellyb · 10th August 2009, 08:31 PM

It's worth mentioning that Medicare's reimbursement policies are shrowded in secrecy..,

("RUC" stands for "Relative Value Scale Update Committee")

http://hcrenewal.blogspot.com/2008/0...d-medical.html

Quote:

The RUC ostensibly is just an advocacy group sponsored by the American Medical Association, yet it seems to be the only source of outside input about physicians' reimbursement used by the US Center for Medicare and Medicaid Services (CMS). Given this influence, it is dismaying that it is secretive, unrepresentative, and unaccountable. Neither its membership nor proceedings are public. It is dominated by proceduralists and sub-specialists. It is unaccountable to US physicians, much less the general public.

And another blog on the RUC:

http://www.medrants.com/archives/3395

Quote:

The story of the RUC often reminds me of conspiracy theories. They (we never really know who they are) determine the fate of the world (or at least the economy). The RUC has disproportionate power and has apparently taken a reasonable idea (RBRVS) and corrupted it. If you want to know who to really blame, it is the RUC. I blame the AMA for developing a committee which does not represent the interest of overall health care, but rather the interests of subspecialties.

If you have access, please read John’s commentary. I have discussed this issue with John in the past, and he has taken the effort to really understand how the RUC impaired our reimbursement system.

Now I do not believe that this is a conscious destruction, nonetheless, I do believe that the RUC has done more to negatively impact outpatient continuity, chronic care than any single entity.

For another excellent commentary on this issue – The pathophysiology of primary care dwindels.

This issue deserves more attention. We must expose this problem and make it reach the national conscious. I fear that it is important but a bit obtuse. I cannot imagine a sound bite approach to the evil the RUC has wrought.

Darth Rotor · 10th August 2009, 08:40 PM

Originally Posted by Rolfe

The entire US system seems, to an outsider, to be completely heartless.

Rolfe.

We thank you for your interest in American affairs.

You gonna send money?

Yeah, I thought not.

uk_dave · 10th August 2009, 11:08 PM

Originally Posted by Darth Rotor

We thank you for your interest in American affairs.

You gonna send money?

Yeah, I thought not.

I was kinda hoping some rich americans would send us money to save us from the brutal NHS.... but it seems that aint happening either.

DC · 11th August 2009, 12:03 AM

Originally Posted by Darth Rotor

We thank you for your interest in American affairs.

You gonna send money?

Yeah, I thought not.

Sell one of your Tanks or Warplanes and you should get enough to getter to get some batteries...

i think heartless is the correct description.

FlamingMoe · 11th August 2009, 04:17 AM

Originally Posted by BenBurch

If you can't see the problem with that, no matter who does it, I can't help you.

Sure thing, Laura Petrie.

Rolfe · 11th August 2009, 04:26 AM

Originally Posted by Darth Rotor

We thank you for your interest in American affairs.

You gonna send money?

Yeah, I thought not.

I did, and I continue to do so. To the Lancasters, and others. It is incomprehensible to me how an adverse health event can devastate citizens of the world's most advanced superpower to such an extent, but I respond as I would to a similar need in a third world country.

Rolfe.

uk_dave · 11th August 2009, 05:26 AM

Originally Posted by Rolfe

.....but I respond as I would to a similar need in a third world country.

Rolfe.

Ouch!

ponderingturtle · 11th August 2009, 12:26 PM

Originally Posted by Darth Rotor

We thank you for your interest in American affairs.

You gonna send money?

Yeah, I thought not.

Yea those companies really work hard to justify their massive overheads and inefficencies in running medicare. We need to support the private sector at all costs.

Chaos · 11th August 2009, 12:44 PM

Originally Posted by Rolfe

I did, and I continue to do so. To the Lancasters, and others. It is incomprehensible to me how an adverse health event can devastate citizens of the world's most advanced superpower to such an extent, but I respond as I would to a similar need in a third world country.

Rolfe.

Ohmer · 11th August 2009, 05:01 PM

Originally Posted by Dictator Cheney

Sell one of your Tanks or Warplanes and you should get enough to getter to get some batteries...

i think heartless is the correct description.

How about this?

http://en.wikipedia.org/wiki/USS_Geo...h_%28CVN-77%29

Barley used, only $6.2 billion*. No? how about:

http://en.wikipedia.org/wiki/USS_Ron...n_%28CVN-76%29

a steal at $4.5 billion*.

*Air wing sold separately.

DC · 11th August 2009, 05:10 PM

Originally Posted by Ohmer

How about this?

http://en.wikipedia.org/wiki/USS_Geo...h_%28CVN-77%29

Barley used, only $6.2 billion*. No? how about:

http://en.wikipedia.org/wiki/USS_Ron...n_%28CVN-76%29

a steal at $4.5 billion*.

*Air wing sold separately.

well that could give some batteries in exchange.

im sure the swiss can get convinced that those are the right tools to defend the coutnry

fits to the F/A 18's

ddt · 11th August 2009, 05:13 PM

Originally Posted by Dictator Cheney

well that could give some batteries in exchange.

im sure the swiss can get convinced that those are the right tools to defend the coutnry

fits to the F/A 18's

(off-topic) That reminds me of the joke about Horthy, the leader of Hungary. Regent in a country without a king, Admiral in a landlocked country.

Rolfe · 11th August 2009, 05:22 PM

You know what? We had a stupid story a week or two ago about NHS patients "being left in agony" because the cruel, stingy NHS had decided their pain-killing injectios were too expensive. Or that was the story, anyway.

It took the British posters about five minutes to demonstrate that the story was about the NHS publishing "best practice" advice that these injections were inappropriate for 80% of the patients they were being given to. And saving money had nothing to do with the decision. And in fact the injections would still be funded for anyone for whom they were clinically appropriate.

The OP is so horrifyingly unlikely that I'm waiting for the US contingent to come in and explain it. Maybe it's bad for the elderly to undergo too many repeated procedures to replace batteries that still have life in them. And maybe the guidelines are just about ensuring that the replacements are only fitted when the old battery really needs replacing. And the rest of it is misreporting.

I could well believe that. It's barbaric, as it's presented. We're used to distortions and blatant lies about the NHS being used for propaganda purposes, and we're cautioned to realise that the same thing can be done to blacken US helathcare porvisions.

So I'm waiting for the reasonable explanation. I really am.

But it's taking a very long time....

Rolfe.

brodski · 11th August 2009, 05:31 PM

Originally Posted by Rolfe

You know what? We had a stupid story a week or two ago about NHS patients "being left in agony" because the cruel, stingy NHS had decided their pain-killing injectios were too expensive. Or that was the story, anyway.

It took the British posters about five minutes to demonstrate that the story was about the NHS publishing "best practice" advice that these injections were inappropriate for 80% of the patients they were being given to. And saving money had nothing to do with the decision. And in fact the injections would still be funded for anyone for whom they were clinically appropriate.

The OP is so horrifyingly unlikely that I'm waiting for the US contingent to come in and explain it. Maybe it's bad for the elderly to undergo too many repeated procedures to replace batteries that still have life in them. And maybe the guidelines are just about ensuring that the replacements are only fitted when the old battery really needs replacing. And the rest of it is misreporting.

I could well believe that. It's barbaric, as it's presented. We're used to distortions and blatant lies about the NHS being used for propaganda purposes, and we're cautioned to realise that the same thing can be done to blacken US helathcare porvisions.

So I'm waiting for the reasonable explanation. I really am.

But it's taking a very long time....

Rolfe.

The trouble is, it is currently in no "sides" interest to defend Medicare/ Medicaid. Proponents of UHC don't want to defend it, cos that shows that the current US system may not be as bad as all that, and opponents of UHC don't want to defend it cos it would show that government run health care isn't as bad as all that.
this is politics, and this story can as easily be spun as anti-UHC as it can be spun as supporting health care reforms, including introducing UHC.

Rolfe · 11th August 2009, 05:39 PM

I don't care which way you spin it, it's a story suggesting that the elderly in the USA who have pacemakers are being treated diabolically.

I would have expected some US posters who know the real situation to come and explain it (if it has an explanation) out of simple decency and national pride.

Rolfe.

ddt · 11th August 2009, 05:58 PM

Originally Posted by BenBurch

http://www.whiterosesociety.org/cont...0-08-2009).mp3

Ben, do you have any indication at which time stamp this lady's story begins? The file is 3 hrs long... Thanks!

kellyb · 11th August 2009, 07:15 PM

I don't have audio on my computer so I can't hear it.

BenBurch · 11th August 2009, 07:44 PM

It was at about the bottom of the second hour I started listening, and she was talking then.

boooeee · 11th August 2009, 08:08 PM

Originally Posted by Rolfe

I don't care which way you spin it, it's a story suggesting that the elderly in the USA who have pacemakers are being treated diabolically.

I would have expected some US posters who know the real situation to come and explain it (if it has an explanation) out of simple decency and national pride.

Rolfe.

I've tried googling various combinations of medicare+pacemaker+new rules+2009+battery and I can't find anything that mentions significant changes to the replacement rules in 2009.

Oddly enough, this thread shows up on the first page for most of my attempted queries.

Since we're more than halfway through 2009 and there's not a blip on this on the internet, I'm skeptical of this woman's characterization of the rule change. But maybe my google-fu is weak.

ddt · 11th August 2009, 08:08 PM

Originally Posted by BenBurch

It was at about the bottom of the second hour I started listening, and she was talking then.

Thanks. It starts at 1:41:10.

kellyb · 11th August 2009, 08:29 PM

Originally Posted by boooeee

I've tried googling various combinations of medicare+pacemaker+new rules+2009+battery and I can't find anything that mentions significant changes to the replacement rules in 2009.

Oddly enough, this thread shows up on the first page for most of my attempted queries.

Since we're more than halfway through 2009 and there's not a blip on this on the internet, I'm skeptical of this woman's characterization of the rule change. But maybe my google-fu is weak.

Same here.

ponderingturtle · 12th August 2009, 04:31 AM

This thread reminded me of a recent news story I overheard my boss listening to. It was about how many AARP members are pissed by the support of that organization for health care reform. See many people on Medicare and Medicaid are actualy very happy with the current system.

And it could well be private medical care in this as well as medicare subsidises companies to run its health care for it at much higher costs.

eeyore1954 · 12th August 2009, 04:47 AM

Originally Posted by BenBurch

I know that "everybody" (in the conservative echo chamber) says that government medical care is going to ration care and kill off the old people.

Well. It appears to be true.

I am listening to a woman on the radio who has been denied a pacemaker battery replacement by Medicare. Her battery is run down. But due to a new medicare rule, they have to run the battery down far past the safe level now, turning off features of the pacemaker, limiting beats to 45 bpm, and shortening the office visit interval in stages down to where the patient has to go in every two weeks and they allow the pacemaker to skip up to 20 beats per minute before increasing its voltage!

This is it; government medical rationing of HEARTBEATS.

The kicker?

The rule took effect on January 1st, 2009, and was a product of the BUSH ADMINISTRATION.

I will post some audio from this later tonight, and I am going to try to get this woman to write her story.

-Ben Burch

If a woman on the radio said it and she doesn't sound like she is lying then it must be true.

Rolfe · 12th August 2009, 05:13 AM

Well, you know, I suspect it isn't true. I suspected that from the start. However, if anyone had made a similar claim about the NHS, ten British posters would have been in the thread explaining what the real situation is with regards to pacemaker batteries, and probably why the woman in the clip had misunderstood the situation.

Don't any American healthcare professionals read these threads?

Rolfe.

DC · 12th August 2009, 05:35 AM

think it should be found here if that is indeed a true regulation.
http://www.cms.hhs.gov/manuals/downl...03c1_Part1.pdf

kellyb · 12th August 2009, 09:22 AM

Originally Posted by Rolfe

Don't any American healthcare professionals read these threads?

Rolfe.

I guess not.
A couple of US MD's have popped in to support tort reform, but that seems to be it.

I guess we'd need a cardiologist who takes Medicare, specifically, to give us the scoop, though.

Rolfe · 12th August 2009, 10:33 AM

I'd have thought a GP would know, it's hardly an uncommon procedure. In fact, I'd have thought that most people working in the healthcare system would know.

Rolfe.

DC · 12th August 2009, 10:49 AM

i think its not true.

Quote:

2. Frequency Guidelines
As with transtelephonic pacemaker monitoring, the frequency of clinic visits is the decision of the patient’s physician, taking into account, among other things, the medical condition of the patient. However, contractors can develop monitoring guidelines that will prove useful in screening claims. The following are recommendations for monitoring guidelines on lithium-battery pacemakers:

i cannot imagen Medicare lets the physician decide about how often the patient can/has to go to the hospital but then is denying a replacement of the battery.

Ohmer · 12th August 2009, 11:52 AM

Originally Posted by Dictator Cheney

i think its not true.

i cannot imagen Medicare lets the physician decide about how often the patient can/has to go to the hospital but then is denying a replacement of the battery.

One of the problems we have with Medicare is that there are lying douche-bags like Rick Scott running hospitals. A guy like him will charge Medicare for double the batteries he needs and pocket the difference. Medicare has to protect itself against such things. If the battery manufacturer say a battery lasts a year and the hospital is charging for one every 6 months, fraud may be involved. I don't know if that it the case here, but stuff like that does happen. It makes life difficult for the patient, the doctor and Medicare.

DC · 12th August 2009, 12:32 PM

Originally Posted by Ohmer

One of the problems we have with Medicare is that there are lying douche-bags like Rick Scott running hospitals. A guy like him will charge Medicare for double the batteries he needs and pocket the difference. Medicare has to protect itself against such things. If the battery manufacturer say a battery lasts a year and the hospital is charging for one every 6 months, fraud may be involved. I don't know if that it the case here, but stuff like that does happen. It makes life difficult for the patient, the doctor and Medicare.

im speachless about the guy....

but you cannot deny the patient his batteries because some guys are cheating. in no way.

ponderingturtle · 12th August 2009, 12:47 PM

Originally Posted by kellyb

I guess not.
A couple of US MD's have popped in to support tort reform, but that seems to be it.

I guess we'd need a cardiologist who takes Medicare, specifically, to give us the scoop, though.

OF course Tort Reform is a BS issue by and large. It is 1% of medical expenses in the US, not any large proportion. So except for some specific feilds it is a non issue with regard to total medical expense.

You might get a couple more percent out of tests to CYA but it is not the driving cost of american health care.

10th August 2009, 06:00 PM	#1
BenBurch Gatekeeper of The Left Join Date: Sep 2007 Location: The Universe 35.2 ms ahead of this one. Posts: 13,785	Rationing of heartbeats by Medicare I know that "everybody" (in the conservative echo chamber) says that government medical care is going to ration care and kill off the old people. Well. It appears to be true. I am listening to a woman on the radio who has been denied a pacemaker battery replacement by Medicare. Her battery is run down. But due to a new medicare rule, they have to run the battery down far past the safe level now, turning off features of the pacemaker, limiting beats to 45 bpm, and shortening the office visit interval in stages down to where the patient has to go in every two weeks and they allow the pacemaker to skip up to 20 beats per minute before increasing its voltage! This is it; government medical rationing of HEARTBEATS. The kicker? The rule took effect on January 1st, 2009, and was a product of the BUSH ADMINISTRATION. I will post some audio from this later tonight, and I am going to try to get this woman to write her story. -Ben Burch
	__________________ A Liberal Dose of Talk Dog is my co-pilot. GENERATION 7: The first time you see this, copy it into your sig on any forum and add 1 to the generation. Social experiment.

10th August 2009, 06:13 PM	#2
DC Formerly The Dictator Cheney Join Date: Mar 2008 Location: Helvetia Posts: 8,407
	__________________ "Creation Science 101"

10th August 2009, 06:31 PM	#3
Rolfe Anti-homeopathy illuminati member Join Date: Sep 2003 Location: NT 150 511 Posts: 19,386	Aw come on. That sounds as big a pile of poo as the worst exaggerations and lies the right-wingers have published about the NHS. Rolfe.
	__________________ "The thing about medicine is, that it all comes down to the numbers." - Dr. Stephen Franklin, Interludes and Examinations. "To give Rolfe his due, I think this is a good example to everyone of what can happen if we fail to get a proper diagnosis and begin treating on symptoms alone--a big mistake, as shown here." - "Snoopy" on H'pathy Forums, apparently abjuring the very fundamentals of homoeopathy after she'd just allowed a young mother with Addison's disease to die.

10th August 2009, 06:39 PM	#4
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619	Originally Posted by Rolfe Aw come on. That sounds as big a pile of poo as the worst exaggerations and lies the right-wingers have published about the NHS. Rolfe. Medicare really is pretty bad right now. They hire private insurance companies to administrate various things (that's where a lot of the money paid to Medicare goes), so, I'm not needing to suspend disbelief for this one. It's our entire system that needs to be revamped from the ground up, medicare included. The Obama admin has already started making improvements by upping the pay to PCPs at the expense of the top-paid sub-specialists. Here's an interesting blog entry on the matter: http://covertrationingblog.com/gener...nts-never-mind Dude's a bit of a conspiracy theorist, but, these are strange times, so...
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619

10th August 2009, 06:54 PM	#5
Rolfe Anti-homeopathy illuminati member Join Date: Sep 2003 Location: NT 150 511 Posts: 19,386	My God, you're system is even more broke than I imagined. And the comments are even more depressing. One person thinks other countries will have to do the same, and the person who replies says that universal healthcare just limits access full stop. The article is essentially saying that Medicare won't reimburse hospitals for events it considers to be avoidable errors in hospital care. Meaning they should swallow the costs, and obviously it's intended as an incentive to stop these things happening. Of course that couldn't happen in the NHS, because the NHS doesn't bill the NHS for looking after patients! The article is pointing out the law of unintended consequences might dictate that in fact doctors will be reluctant to recommend an elective procedure in a vulnerable elderly patient, for fear one of these things happens and costs the hospital a lot of money. Which certainly sounds possible. The entire US system seems, to an outsider, to be completely heartless. Rolfe.
	__________________ "The thing about medicine is, that it all comes down to the numbers." - Dr. Stephen Franklin, Interludes and Examinations. "To give Rolfe his due, I think this is a good example to everyone of what can happen if we fail to get a proper diagnosis and begin treating on symptoms alone--a big mistake, as shown here." - "Snoopy" on H'pathy Forums, apparently abjuring the very fundamentals of homoeopathy after she'd just allowed a young mother with Addison's disease to die.

10th August 2009, 07:04 PM	#6
BenBurch Gatekeeper of The Left Join Date: Sep 2007 Location: The Universe 35.2 ms ahead of this one. Posts: 13,785	Originally Posted by Rolfe Aw come on. That sounds as big a pile of poo as the worst exaggerations and lies the right-wingers have published about the NHS. Rolfe. Show archive posting is in 20 minutes. I will post a link here and you can listen for yourself. She did not sound like she was lying to me!
	__________________ A Liberal Dose of Talk Dog is my co-pilot. GENERATION 7: The first time you see this, copy it into your sig on any forum and add 1 to the generation. Social experiment.

10th August 2009, 07:05 PM	#7
FlamingMoe Muse Join Date: Jan 2009 Location: Your mom's house. Posts: 721	Originally Posted by BenBurch This is it; government medical rationing of HEARTBEATS. The kicker? The rule took effect on January 1st, 2009, and was a product of the BUSH ADMINISTRATION. How is this "the kicker"? Medicare is expensive and costs need to be cut. This is true across all administrations.

10th August 2009, 07:08 PM	#8
BenBurch Gatekeeper of The Left Join Date: Sep 2007 Location: The Universe 35.2 ms ahead of this one. Posts: 13,785	Originally Posted by FlamingMoe How is this "the kicker"? Medicare is expensive and costs need to be cut. This is true across all administrations. If you can't see the problem with that, no matter who does it, I can't help you.
	__________________ A Liberal Dose of Talk Dog is my co-pilot. GENERATION 7: The first time you see this, copy it into your sig on any forum and add 1 to the generation. Social experiment.

10th August 2009, 07:59 PM	#9
BenBurch Gatekeeper of The Left Join Date: Sep 2007 Location: The Universe 35.2 ms ahead of this one. Posts: 13,785	http://www.whiterosesociety.org/cont...0-08-2009).mp3
	__________________ A Liberal Dose of Talk Dog is my co-pilot. GENERATION 7: The first time you see this, copy it into your sig on any forum and add 1 to the generation. Social experiment.

10th August 2009, 08:31 PM	#10
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619	It's worth mentioning that Medicare's reimbursement policies are shrowded in secrecy.., ("RUC" stands for "Relative Value Scale Update Committee") http://hcrenewal.blogspot.com/2008/0...d-medical.html Quote: The RUC ostensibly is just an advocacy group sponsored by the American Medical Association, yet it seems to be the only source of outside input about physicians' reimbursement used by the US Center for Medicare and Medicaid Services (CMS). Given this influence, it is dismaying that it is secretive, unrepresentative, and unaccountable. Neither its membership nor proceedings are public. It is dominated by proceduralists and sub-specialists. It is unaccountable to US physicians, much less the general public. And another blog on the RUC: http://www.medrants.com/archives/3395 Quote: The story of the RUC often reminds me of conspiracy theories. They (we never really know who they are) determine the fate of the world (or at least the economy). The RUC has disproportionate power and has apparently taken a reasonable idea (RBRVS) and corrupted it. If you want to know who to really blame, it is the RUC. I blame the AMA for developing a committee which does not represent the interest of overall health care, but rather the interests of subspecialties. If you have access, please read John’s commentary. I have discussed this issue with John in the past, and he has taken the effort to really understand how the RUC impaired our reimbursement system. Now I do not believe that this is a conscious destruction, nonetheless, I do believe that the RUC has done more to negatively impact outpatient continuity, chronic care than any single entity. For another excellent commentary on this issue – The pathophysiology of primary care dwindels. This issue deserves more attention. We must expose this problem and make it reach the national conscious. I fear that it is important but a bit obtuse. I cannot imagine a sound bite approach to the evil the RUC has wrought.
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619

10th August 2009, 08:40 PM	#11
Darth Rotor Salted Sith Cynic Join Date: Aug 2006 Location: Rat cheer Posts: 26,802	Originally Posted by Rolfe The entire US system seems, to an outsider, to be completely heartless. Rolfe. We thank you for your interest in American affairs. You gonna send money? Yeah, I thought not.
	__________________ Helicopters don't so much fly as beat the air into submission. "Jesus wept, but did He laugh?"--F.H. Buckley____"There is some one thing that was too great for God to show us when He walked upon our earth ... His mirth." --Chesterton____"Atheism is no safeguard against stupidity."--The Atheist____If the barbarian in us is excised, so is our humanity."--D'rok____ "Your onus is aimed in the wrong direction." -- Cleon

10th August 2009, 11:08 PM	#12
uk_dave Philosopher Join Date: Oct 2006 Posts: 5,627	Originally Posted by Darth Rotor We thank you for your interest in American affairs. You gonna send money? Yeah, I thought not. I was kinda hoping some rich americans would send us money to save us from the brutal NHS.... but it seems that aint happening either.
uk_dave Philosopher Join Date: Oct 2006 Posts: 5,627	__________________ Those evil-natured robots they're programmed to destroy us she's gotta be strong to fight them so she's taking lots of vitamins

11th August 2009, 12:03 AM	#13
DC Formerly The Dictator Cheney Join Date: Mar 2008 Location: Helvetia Posts: 8,407	Originally Posted by Darth Rotor We thank you for your interest in American affairs. You gonna send money? Yeah, I thought not. Sell one of your Tanks or Warplanes and you should get enough to getter to get some batteries... i think heartless is the correct description.
	__________________ "Creation Science 101"

11th August 2009, 04:17 AM	#14
FlamingMoe Muse Join Date: Jan 2009 Location: Your mom's house. Posts: 721	Originally Posted by BenBurch If you can't see the problem with that, no matter who does it, I can't help you. Sure thing, Laura Petrie.

11th August 2009, 04:26 AM	#15
Rolfe Anti-homeopathy illuminati member Join Date: Sep 2003 Location: NT 150 511 Posts: 19,386	Originally Posted by Darth Rotor We thank you for your interest in American affairs. You gonna send money? Yeah, I thought not. I did, and I continue to do so. To the Lancasters, and others. It is incomprehensible to me how an adverse health event can devastate citizens of the world's most advanced superpower to such an extent, but I respond as I would to a similar need in a third world country. Rolfe.
	__________________ "The thing about medicine is, that it all comes down to the numbers." - Dr. Stephen Franklin, Interludes and Examinations. "To give Rolfe his due, I think this is a good example to everyone of what can happen if we fail to get a proper diagnosis and begin treating on symptoms alone--a big mistake, as shown here." - "Snoopy" on H'pathy Forums, apparently abjuring the very fundamentals of homoeopathy after she'd just allowed a young mother with Addison's disease to die.

11th August 2009, 05:26 AM	#16
uk_dave Philosopher Join Date: Oct 2006 Posts: 5,627	Originally Posted by Rolfe .....but I respond as I would to a similar need in a third world country. Rolfe. Ouch!
uk_dave Philosopher Join Date: Oct 2006 Posts: 5,627	__________________ Those evil-natured robots they're programmed to destroy us she's gotta be strong to fight them so she's taking lots of vitamins

11th August 2009, 12:26 PM	#17
ponderingturtle Orthogonal Vector Join Date: Jul 2006 Location: Ossining NY Posts: 18,770	Originally Posted by Darth Rotor We thank you for your interest in American affairs. You gonna send money? Yeah, I thought not. Yea those companies really work hard to justify their massive overheads and inefficencies in running medicare. We need to support the private sector at all costs.
	__________________ Sufficiently advanced Woo is indistinguishable from Parody "There shall be no poofing in science" Paul C. Anagnostopoulos Force ***** on reasons back" Ben Franklin

11th August 2009, 12:44 PM	#18
Chaos TAM Chocolate Dispenser Join Date: Sep 2003 Location: The Heart of Old Europe Posts: 6,360	Originally Posted by Rolfe I did, and I continue to do so. To the Lancasters, and others. It is incomprehensible to me how an adverse health event can devastate citizens of the world's most advanced superpower to such an extent, but I respond as I would to a similar need in a third world country. Rolfe.
	__________________ Grand Master, Knights of the Question Mark Illusion: too good to be true - Reality: too true to be good Authors build castles in the sky, readers live in them and publishers collect the rent. - Maxim Gorki Folks enjoy a witch-hunt as long as they are on the blunt end of the pitchfork. - Suezoled You can't use logic to talk a man out of a position that he didn't use logic to get himself into - passed down by Nyarlathotep Kids these days are better than their parents since they constitute the newest edition, the beta version of our societies - Cleopatra YouÂ´ll have to accept the fact that some people are just plain nuts. - Paul C. Anagnostopolous

11th August 2009, 05:01 PM	#19
Ohmer Muse Join Date: Oct 2004 Location: Portland Oregon Posts: 614	Originally Posted by Dictator Cheney Sell one of your Tanks or Warplanes and you should get enough to getter to get some batteries... i think heartless is the correct description. How about this? http://en.wikipedia.org/wiki/USS_Geo...h_%28CVN-77%29 Barley used, only $6.2 billion. No? how about: http://en.wikipedia.org/wiki/USS_Ron...n_%28CVN-76%29 a steal at $4.5 billion. *Air wing sold separately.

11th August 2009, 05:10 PM	#20
DC Formerly The Dictator Cheney Join Date: Mar 2008 Location: Helvetia Posts: 8,407	Originally Posted by Ohmer How about this? http://en.wikipedia.org/wiki/USS_Geo...h_%28CVN-77%29 Barley used, only $6.2 billion. No? how about: http://en.wikipedia.org/wiki/USS_Ron...n_%28CVN-76%29 a steal at $4.5 billion. *Air wing sold separately. well that could give some batteries in exchange. im sure the swiss can get convinced that those are the right tools to defend the coutnry fits to the F/A 18's
	__________________ "Creation Science 101" Last edited by DC; 11th August 2009 at 05:12 PM.

11th August 2009, 05:13 PM	#21
ddt Mafia Penguin Join Date: Dec 2007 Location: Netherlands Posts: 4,084	Originally Posted by Dictator Cheney well that could give some batteries in exchange. im sure the swiss can get convinced that those are the right tools to defend the coutnry fits to the F/A 18's (off-topic) That reminds me of the joke about Horthy, the leader of Hungary. Regent in a country without a king, Admiral in a landlocked country.
	__________________ Proud member of the Solipsistic Autosycophant's Group I think I see a signature - nathan

11th August 2009, 05:22 PM	#22
Rolfe Anti-homeopathy illuminati member Join Date: Sep 2003 Location: NT 150 511 Posts: 19,386	You know what? We had a stupid story a week or two ago about NHS patients "being left in agony" because the cruel, stingy NHS had decided their pain-killing injectios were too expensive. Or that was the story, anyway. It took the British posters about five minutes to demonstrate that the story was about the NHS publishing "best practice" advice that these injections were inappropriate for 80% of the patients they were being given to. And saving money had nothing to do with the decision. And in fact the injections would still be funded for anyone for whom they were clinically appropriate. The OP is so horrifyingly unlikely that I'm waiting for the US contingent to come in and explain it. Maybe it's bad for the elderly to undergo too many repeated procedures to replace batteries that still have life in them. And maybe the guidelines are just about ensuring that the replacements are only fitted when the old battery really needs replacing. And the rest of it is misreporting. I could well believe that. It's barbaric, as it's presented. We're used to distortions and blatant lies about the NHS being used for propaganda purposes, and we're cautioned to realise that the same thing can be done to blacken US helathcare porvisions. So I'm waiting for the reasonable explanation. I really am. But it's taking a very long time.... Rolfe.
	__________________ "The thing about medicine is, that it all comes down to the numbers." - Dr. Stephen Franklin, Interludes and Examinations. "To give Rolfe his due, I think this is a good example to everyone of what can happen if we fail to get a proper diagnosis and begin treating on symptoms alone--a big mistake, as shown here." - "Snoopy" on H'pathy Forums, apparently abjuring the very fundamentals of homoeopathy after she'd just allowed a young mother with Addison's disease to die.

11th August 2009, 05:31 PM	#23
brodski faceless bureaucrat Join Date: Mar 2005 Location: the three Chiltern Hundreds of Stoke, Desborough and Burnham Posts: 11,789	Originally Posted by Rolfe You know what? We had a stupid story a week or two ago about NHS patients "being left in agony" because the cruel, stingy NHS had decided their pain-killing injectios were too expensive. Or that was the story, anyway. It took the British posters about five minutes to demonstrate that the story was about the NHS publishing "best practice" advice that these injections were inappropriate for 80% of the patients they were being given to. And saving money had nothing to do with the decision. And in fact the injections would still be funded for anyone for whom they were clinically appropriate. The OP is so horrifyingly unlikely that I'm waiting for the US contingent to come in and explain it. Maybe it's bad for the elderly to undergo too many repeated procedures to replace batteries that still have life in them. And maybe the guidelines are just about ensuring that the replacements are only fitted when the old battery really needs replacing. And the rest of it is misreporting. I could well believe that. It's barbaric, as it's presented. We're used to distortions and blatant lies about the NHS being used for propaganda purposes, and we're cautioned to realise that the same thing can be done to blacken US helathcare porvisions. So I'm waiting for the reasonable explanation. I really am. But it's taking a very long time.... Rolfe. The trouble is, it is currently in no "sides" interest to defend Medicare/ Medicaid. Proponents of UHC don't want to defend it, cos that shows that the current US system may not be as bad as all that, and opponents of UHC don't want to defend it cos it would show that government run health care isn't as bad as all that. this is politics, and this story can as easily be spun as anti-UHC as it can be spun as supporting health care reforms, including introducing UHC.
	__________________ ...and the story does suggest a part 2 to the Turing Test: 1. can machines behave like humans? 2. can we?

11th August 2009, 05:39 PM	#24
Rolfe Anti-homeopathy illuminati member Join Date: Sep 2003 Location: NT 150 511 Posts: 19,386	I don't care which way you spin it, it's a story suggesting that the elderly in the USA who have pacemakers are being treated diabolically. I would have expected some US posters who know the real situation to come and explain it (if it has an explanation) out of simple decency and national pride. Rolfe.
	__________________ "The thing about medicine is, that it all comes down to the numbers." - Dr. Stephen Franklin, Interludes and Examinations. "To give Rolfe his due, I think this is a good example to everyone of what can happen if we fail to get a proper diagnosis and begin treating on symptoms alone--a big mistake, as shown here." - "Snoopy" on H'pathy Forums, apparently abjuring the very fundamentals of homoeopathy after she'd just allowed a young mother with Addison's disease to die.

11th August 2009, 05:58 PM	#25
ddt Mafia Penguin Join Date: Dec 2007 Location: Netherlands Posts: 4,084	Originally Posted by BenBurch http://www.whiterosesociety.org/cont...0-08-2009).mp3 Ben, do you have any indication at which time stamp this lady's story begins? The file is 3 hrs long... Thanks!
	__________________ Proud member of the Solipsistic Autosycophant's Group I think I see a signature - nathan

11th August 2009, 07:15 PM	#26
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619	I don't have audio on my computer so I can't hear it.
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619

11th August 2009, 07:44 PM	#27
BenBurch Gatekeeper of The Left Join Date: Sep 2007 Location: The Universe 35.2 ms ahead of this one. Posts: 13,785	It was at about the bottom of the second hour I started listening, and she was talking then.
	__________________ A Liberal Dose of Talk Dog is my co-pilot. GENERATION 7: The first time you see this, copy it into your sig on any forum and add 1 to the generation. Social experiment.

11th August 2009, 08:08 PM	#28
boooeee Dart Fener Join Date: Aug 2002 Location: The Lando System Posts: 1,867	Originally Posted by Rolfe I don't care which way you spin it, it's a story suggesting that the elderly in the USA who have pacemakers are being treated diabolically. I would have expected some US posters who know the real situation to come and explain it (if it has an explanation) out of simple decency and national pride. Rolfe. I've tried googling various combinations of medicare+pacemaker+new rules+2009+battery and I can't find anything that mentions significant changes to the replacement rules in 2009. Oddly enough, this thread shows up on the first page for most of my attempted queries. Since we're more than halfway through 2009 and there's not a blip on this on the internet, I'm skeptical of this woman's characterization of the rule change. But maybe my google-fu is weak.
	__________________ "I have observed that the world has suffered far less from ignorance than from pretensions to knowledge. It is not skeptics or explorers but fanatics and ideologues who menace decency and progress." - Daniel Boorstin "When the only tool you have is a hammer, pretty soon all your problems look like squirrels." - NoZed Avenger

11th August 2009, 08:08 PM	#29
ddt Mafia Penguin Join Date: Dec 2007 Location: Netherlands Posts: 4,084	Originally Posted by BenBurch It was at about the bottom of the second hour I started listening, and she was talking then. Thanks. It starts at 1:41:10.
	__________________ Proud member of the Solipsistic Autosycophant's Group I think I see a signature - nathan

11th August 2009, 08:29 PM	#30
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619	Originally Posted by boooeee I've tried googling various combinations of medicare+pacemaker+new rules+2009+battery and I can't find anything that mentions significant changes to the replacement rules in 2009. Oddly enough, this thread shows up on the first page for most of my attempted queries. Since we're more than halfway through 2009 and there's not a blip on this on the internet, I'm skeptical of this woman's characterization of the rule change. But maybe my google-fu is weak. Same here.
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619

12th August 2009, 04:31 AM	#31
ponderingturtle Orthogonal Vector Join Date: Jul 2006 Location: Ossining NY Posts: 18,770	This thread reminded me of a recent news story I overheard my boss listening to. It was about how many AARP members are pissed by the support of that organization for health care reform. See many people on Medicare and Medicaid are actualy very happy with the current system. And it could well be private medical care in this as well as medicare subsidises companies to run its health care for it at much higher costs.
	__________________ Sufficiently advanced Woo is indistinguishable from Parody "There shall be no poofing in science" Paul C. Anagnostopoulos Force ***** on reasons back" Ben Franklin

12th August 2009, 04:47 AM	#32
eeyore1954 Muse Join Date: Jun 2006 Posts: 733	Originally Posted by BenBurch I know that "everybody" (in the conservative echo chamber) says that government medical care is going to ration care and kill off the old people. Well. It appears to be true. I am listening to a woman on the radio who has been denied a pacemaker battery replacement by Medicare. Her battery is run down. But due to a new medicare rule, they have to run the battery down far past the safe level now, turning off features of the pacemaker, limiting beats to 45 bpm, and shortening the office visit interval in stages down to where the patient has to go in every two weeks and they allow the pacemaker to skip up to 20 beats per minute before increasing its voltage! This is it; government medical rationing of HEARTBEATS. The kicker? The rule took effect on January 1st, 2009, and was a product of the BUSH ADMINISTRATION. I will post some audio from this later tonight, and I am going to try to get this woman to write her story. -Ben Burch If a woman on the radio said it and she doesn't sound like she is lying then it must be true.
eeyore1954 Muse Join Date: Jun 2006 Posts: 733

12th August 2009, 05:13 AM	#33
Rolfe Anti-homeopathy illuminati member Join Date: Sep 2003 Location: NT 150 511 Posts: 19,386	Well, you know, I suspect it isn't true. I suspected that from the start. However, if anyone had made a similar claim about the NHS, ten British posters would have been in the thread explaining what the real situation is with regards to pacemaker batteries, and probably why the woman in the clip had misunderstood the situation. Don't any American healthcare professionals read these threads? Rolfe.
	__________________ "The thing about medicine is, that it all comes down to the numbers." - Dr. Stephen Franklin, Interludes and Examinations. "To give Rolfe his due, I think this is a good example to everyone of what can happen if we fail to get a proper diagnosis and begin treating on symptoms alone--a big mistake, as shown here." - "Snoopy" on H'pathy Forums, apparently abjuring the very fundamentals of homoeopathy after she'd just allowed a young mother with Addison's disease to die.

12th August 2009, 05:35 AM	#34
DC Formerly The Dictator Cheney Join Date: Mar 2008 Location: Helvetia Posts: 8,407	think it should be found here if that is indeed a true regulation. http://www.cms.hhs.gov/manuals/downl...03c1_Part1.pdf
	__________________ "Creation Science 101"

12th August 2009, 09:22 AM	#35
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619	Originally Posted by Rolfe Don't any American healthcare professionals read these threads? Rolfe. I guess not. A couple of US MD's have popped in to support tort reform, but that seems to be it. I guess we'd need a cardiologist who takes Medicare, specifically, to give us the scoop, though.
kellyb Master Poster Join Date: Jan 2006 Posts: 2,619