How are we going to handle obamacare?

[txted]

I fully expect the Senate to vote the Obamacare bill out of the Senate and over to the house to restructure both bills into one. I don't have any expectations that the bill will stall in the house. I expect the Senate to rubber stamp the new house bill and send it to Obama for his signature. At that point I believe the American people are really screwed for a lot of reasons.

One immediate problem will be availability of physicians to care for the expanded patient base. I am curious how many physicians from other countries will remain in the United States with socialized medicine. I listened to the president of the American Medical Association say recently that we already have a physician shortage in the U.S. but they support Obamacare anyhow.

I am curious about how physicians operate in states other than Texas. I don't know if a uniform method or code of practice exists for all states, or does each state establish its distinct rules. In Texas, we have the option of visiting a specialist for care (primary care physicians are slowly or quickly disappearing) or visiting a "Nurse Practitioner" or "Physicians Assistant" clinic. Both professions have diagnostic and treatment authority for primary care. They practice under the professional guidance of a licensed physician, but it is not necessary for the physician to be on premises. They also write prescriptions for the physician. I live in a small town which has both a Physicians Assistant clinic and a Nurse Practitioner clinic. I know both practices have legal limitations, but I don't know what they are. In both cases the actual physicians office is probably 40 miles away. Do other states have the same type of medical clinic availability?

I believe when Obamacare is up and running, we will need to expand the authority of the practitioners and assistants to have the same treatment authority as todays primary care physician. They can redesignate them as "certified or licensed medical specialists". They will need to be able to practice medicine without the requirement that they are supervised by a physician. They should have legal limitations on the type of treatments they can provide as well as limitations on the type of prescriptions they can write. Conditions which do not fall under their allowed treatments, must by law be referred to a specialist. The exception to that rule will be dependent on the availability of a specialist for treatment.

I have no doubt that physicians groups will fight any expansion of treatment authority to the death. I simply see no other way to expand medical care to all.

What do you think?

txted

[GOP Congress]

I realize you are looking for specifics, but first things first: This is, frankly, not so much a Health Care bill, but a bill that puts out the building blocks for fundamentally changing ALL aspects of Americans' lives.

To be blunt, the bill is nothing more than intentionally-produced crap. But it represents far more than just a destruction of our health care system.

If allowed to stand, this bill will represent the official death blow to American capitalism and individual rights. December 24, 2009, will be refered to as such. If July 4, 1776 is the birth day, then this Thursday will represent the final day of this country as we know it under the Declaration of Independence, and the subsequent Constitution.

However...

I don't believe that this bill will be allowed to stand. Quite simply, this is nothing but a photo-op, a signature piece to represent America's greatest lurch to the left in history. But until the 2010 elections are held, this day can go either way.

You talk about specifics in your very pertinent and precipitous questions. The problem is that the CONFUSION of the bill is PRECISELY what the democrats want. They want to be able to take all existing methods of accountability, specialist assignments, treatment authority, and other information that you present. And I've one of the few people who've actually read the bill from what sources I could obtain them from, and it's flat out IMPOSSIBLE to come up with ANY SEMBLANCE of realty.

Which cements in my mind that his has LITTLE to do with health, but MUCH to do with government control, and EVEN GREATER to do with economic theft from the producers to the thieves.

In short, this is not a Health Care bill. This is, without question, closer to being called The American Socialist Act of 2009 more than anything to do with dispensing aspirins.

Again, I know you are looking for specifics. Such specifics are impossible to ascertain. The reasoning why they are impossible to ascertain is deliberate. So I can't help you in any way there. You MAY get some semblance of new protocols, but I ddfy ANYONE to tell me what those protocols actually mean until they try to implement it.

[Carl]

What will happen within a year or two is the increased burden on the states to pick up the cost of the new medicaid recipients will drive local and state taxes to the point where the middle class will be effectively reduced to poverty.
The outcry will be met with more government control to "ease" the burden with a complete takeover by the 2012 elections so that O can run against whoever by saying he/she wants to take away your health care.

Just my guess and if right as GOP just said the logistics of the bill matter little as they are only temporary.

[rich_t]

Which cements in my mind that his has LITTLE to do with health, but MUCH to do with government control, and EVEN GREATER to do with economic theft from the producers to the thieves.

Folks,

Take a look at the federal legislation passed in the last 4 decades or so.  The majority of it has been about establishing more governmental control of the lives of the people. 

Hell, even the SCOTUS has lost it's freaking mind by allowing emminent domain to take private property for non-public use.

It's been going on in dribs and drabs and small nibbles.  This time they are going for a big bite and it has folks upset.  Well guess what? 

They should have been upset all along and fighting back.

But no... the American public in it's apathy has allowed the government to reach the point it has.  It is good that at least a segment of the public is starting to wake up, but I can't help but wonder if it's too litte and too late. 

As for me, I am doing the best I can to prepare for the anarchy that is sure to come unless a majority of the public wakes the hell up and starts to take their country back from the royal families in DC.

We have ourselves to blame and it's up to us to fix it.  If it's not too late.

[bkg]

mark my words... you are going to see a massive increase in suicide after this goes through. it will be the only way some folks will know how to "cope" with what is happening. both those who are in pain and those who simply have lost the will to live through communist reign.

[IassaFTots]

Folks,

Take a look at the federal legislation passed in the last 4 decades or so.  The majority of it has been about establishing more governmental control of the lives of the people. 

Hell, even the SCOTUS has lost it's freaking mind by allowing emminent domain to take private property for non-public use.

It's been going on in dribs and drabs and small nibbles.  This time they are going for a big bite and it has folks upset.  Well guess what? 

They should have been upset all along and fighting back.

But no... the American public in it's apathy has allowed the government to reach the point it has.  It is good that at least a segment of the public is starting to wake up, but I can't help but wonder if it's too litte and too late. 

As for me, I am doing the best I can to prepare for the anarchy that is sure to come unless a majority of the public wakes the hell up and starts to take their country back from the royal families in DC.

We have ourselves to blame and it's up to us to fix it.  If it's not too late.

I couldn't have said it better myself.   

[DumbAss Tanker]

Realistically, where are the foreign docs going to go to get a better deal?  Anyplace else in the West already has some kind of socialized medicine, and going back to Mumbai isn't exactly an improvement in their circumstances.
In the really short term, I think we just have to accept being screwed and regroup for Congressional turnover and repeal before the benefits start being paid out and become embedded as Democrat Voter Crack.
Elections have consequences, including the 2008 primary process that gave us McCain, and we have to accept that and knuckle down to see it doesn't happen again in 2010 and 2012.

[txted]

I agree with everything that has been said in the previous posts. If the bill makes it to the presidents desk and he signs it, questions of it's constitutionality are the only hope we have of stopping it. By the time it reaches the Supreme court, the news media and the citizens will be embroiled over questions of "card check" and "cap  & trade" legislation. That should get us to the 2010 elections and the possibility they can be stopped. If SCOSUS accepts the obamacare bill, at least parts of the bill will be declared unconstitutional. I believe SCOSUS will decline to hear the suit on the bill. I sincerely hope they will hear the case.

The very size of the bureaucracy and the structures to contain it will be massive. The federal government has never established a bureaucracy that actually cost what was projected. Once built and deployed, it will be like a gigantic cancer on the health of America. The only way to remove it will be to kill the patient.

Now, back to my question; how can the American medical industry restructure itself in order to accomodate the influx of new patients? Even if many of the foreign physicians don't elect to move somewhere else to practice, the influx of new physicians from foreign countries will either stop or slow down. Many currently practicing physicians who have saved a little money will elect to retire rather than practice assembly line medicine. When obamacare is in place and the gigantic bureacracy is up and running or stumbling along, what can be done to obtain decent medical care?

txted

[DumbAss Tanker]

Even if many of the foreign physicians don't elect to move somewhere else to practice, the influx of new physicians from foreign countries will either stop or slow down.

I agree completely with that, I omitted going into that aspect in my previous post for the sake of brevity. 

The ones that are already here won't have greener pastures offshore, but by the same token we won't look nearly so green to anyone looking to build a lucrative career and with the liberty to go anywhere to start.  It makes more sense for them to go someplace else that's hard-over Socialist to take care of all their own family's baseline needs, but does not have the ulimited risk of loss and corresponding astronomical malpractice insurance costs that our unreformed tort law system has.

A new practitioner has better long-term career potential elsewhere, despite the high taxes that go with the full-bore Socialism.  We're rapidly headed to a point where our tax structure will not offer any advantage to offset the massive costs pushed onto the providers by our tort law system and noncompetitive medical insurance structure (Neither one of which are touched by the so-called HCR, since due to special interest ties Congress won't be fixing the things that actually ARE broken in our system, but instead will be 'Fixting' things that aren't).   

[Ladywinter]

I agree with everything that has been said in the previous posts. If the bill makes it to the presidents desk and he signs it, questions of it's constitutionality are the only hope we have of stopping it. By the time it reaches the Supreme court, the news media and the citizens will be embroiled over questions of "card check" and "cap  & trade" legislation. That should get us to the 2010 elections and the possibility they can be stopped. If SCOSUS accepts the obamacare bill, at least parts of the bill will be declared unconstitutional. I believe SCOSUS will decline to hear the suit on the bill. I sincerely hope they will hear the case.

The very size of the bureaucracy and the structures to contain it will be massive. The federal government has never established a bureaucracy that actually cost what was projected. Once built and deployed, it will be like a gigantic cancer on the health of America. The only way to remove it will be to kill the patient.

Now, back to my question; how can the American medical industry restructure itself in order to accomodate the influx of new patients? Even if many of the foreign physicians don't elect to move somewhere else to practice, the influx of new physicians from foreign countries will either stop or slow down. Many currently practicing physicians who have saved a little money will elect to retire rather than practice assembly line medicine. When obamacare is in place and the gigantic bureacracy is up and running or stumbling along, what can be done to obtain decent medical care?

txted

I don't have any answer(s) for you either txted.  All that has been written in this thread, I completely agree with.  I have talked with my own private physician about the HC reform bill and he believes this will be the first  "hit" to America.  (Cap and Trade being the "final kill shot", and that's a whole new subject.)  

He plans to retire IF this HC reform bill debacle passes because he said he simply will not be able to afford keeping his practice up and running.  His words...  We both just took a deep breath at that point.  

I visualize this:  Long, long lines.  Making an appointment to be "seen" will take weeks.  Middle class America will not be able to handle the increase in premium costs, and we'll all end up in jail for lack of paying them.  The upside to this is, in jail not only will we get free food, free dental, free internet, free work-out rooms, etc.  BUT FREE MEDICAL... gawd  

[txted]

I don't have any answer(s) for you either txted.  All that has been written in this thread, I completely agree with.  I have talked with my own private physician about the HC reform bill and he believes this will be the first  "hit" to America.  (Cap and Trade being the "final kill shot", and that's a whole new subject.)  

He plans to retire IF this HC reform bill debacle passes because he said he simply will not be able to afford keeping his practice up and running.  His words...  We both just took a deep breath at that point.  

I visualize this:  Long, long lines.  Making an appointment to be "seen" will take weeks.  Middle class America will not be able to handle the increase in premium costs, and we'll all end up in jail for lack of paying them.  The upside to this is, in jail not only will we get free food, free dental, free internet, free work-out rooms, etc.  BUT FREE MEDICAL... gawd  

One good aspect of the jail option will be the fact that when all of middle America is in prison, our masters will no longer have to be concerned about the racial imbalance that currently exists in prison.

txted

[DefiantSix]

One good aspect of the jail option will be the fact that when all of middle America is in prison, our masters will no longer have to be concerned about the racial imbalance that currently exists in prison.

txted

I really don't want to come out sounding like some rabid, foaming at the mouth revolutionary, but if Lord Ø's minions are going to drop me in prison anyway, then *******it, the least I can do is to make it worth my while, and worthy of their best efforts.  Somehow, I'm just going to have to make myself the biggest pain in the ass Big Brotha has had this week.

[Oceander]

[thundley4]

One good aspect of the jail option will be the fact that when all of middle America is in prison, our masters will no longer have to be concerned about the racial imbalance that currently exists in prison.

txted

I had read somewhere that penalties over and above the 2% tax on income had been done away with.  Since the IRS is going to be the enforcement arm for mandated insurance, they didn't see a need to add on other penalties I guess.  OTOH, the IRS could still throw your ass in jail for tax evasion, it just wouldn't be tied to the HCR bill.

[Oceander]

[Oceander]

I had read somewhere that penalties over and above the 2% tax on income had been done away with.  Since the IRS is going to be the enforcement arm for mandated insurance, they didn't see a need to add on other penalties I guess.  OTOH, the IRS could still throw your ass in jail for tax evasion, it just wouldn't be tied to the HCR bill.

Which suggests that, when it comes right down to it, they won't have the cojones to put their money where their mouths are, and that the best way to bring the whole b.s. crashing to the ground is for every patriotic American to simply refuse to pay the Obamatax, and refuse to settle with the IRS when they assess it as a deficiency - the IRS would end up with so many cases in the Collection Division that they would simply be swamped and unable to collect anything, and the public outcry over, e.g., seizing houses and bank accounts and businesses to pay the Obamatax would make the public outcry that got us the Taxpayer Bill of Rights back in 1998 look like a pro-IRS demonstration by comparison.

[txted]

Which suggests that, when it comes right down to it, they won't have the cojones to put their money where their mouths are, and that the best way to bring the whole b.s. crashing to the ground is for every patriotic American to simply refuse to pay the Obamatax, and refuse to settle with the IRS when they assess it as a deficiency - the IRS would end up with so many cases in the Collection Division that they would simply be swamped and unable to collect anything, and the public outcry over, e.g., seizing houses and bank accounts and businesses to pay the Obamatax would make the public outcry that got us the Taxpayer Bill of Rights back in 1998 look like a pro-IRS demonstration by comparison.

And even advising your fellow Americans to not pay their taxes can get you a term in prison. You insurrectionist.

txted

[Carl]

Which suggests that, when it comes right down to it, they won't have the cojones to put their money where their mouths are, and that the best way to bring the whole b.s. crashing to the ground is for every patriotic American to simply refuse to pay the Obamatax, and refuse to settle with the IRS when they assess it as a deficiency - the IRS would end up with so many cases in the Collection Division that they would simply be swamped and unable to collect anything, and the public outcry over, e.g., seizing houses and bank accounts and businesses to pay the Obamatax would make the public outcry that got us the Taxpayer Bill of Rights back in 1998 look like a pro-IRS demonstration by comparison.

Unless you are self employed you won`t have a chance...called withholding,I have no doubt an employer will be required to know your insurance status.
You can lie I guess and say you do but also have no doubt proof of such will be part of the tax return.

Not to be a wet rag on that issue but it will not be in our hands.

[thundley4]

Unless you are self employed you won`t have a chance...called withholding,I have no doubt an employer will be required to know your insurance status.
You can lie I guess and say you do but also have no doubt proof of such will be part of the tax return.

Not to be a wet rag on that issue but it will not be in our hands.

That is why I think they put the enforcement in the hands of the IRS.  The IRS already has the ability to attach liens to wages, savings and whatever else.

[Baruch Menachem]

Assuming it does get to his desk.   He has only 3 votes in the house as a cushion, and there are several deal killing provisions in the senate to the house members.   It may just fail conference

[DumbAss Tanker]

Assuming it does get to his desk.   He has only 3 votes in the house as a cushion, and there are several deal killing provisions in the senate to the house members.   It may just fail conference

Don't count on that, the close vote in the House was a dance of carefully-staged pageantry, with Pope Nancy passing out the indulgences from a jealously-guarded and carefully-counted supply.  If it comes to it, some of the previous Dem 'Nays' will be expected to pay up if it becomes necessary for her to call in the marker on them, and throw themselves on the spikes for the good of the Dear Leader and his Prosperity and Health Plan. 

[bkg]

Don't count on that, the close vote in the House was a dance of carefully-staged pageantry, with Pope Nancy passing out the indulgences from a jealously-guarded and carefully-counted supply.  If it comes to it, some of the previous Dem 'Nays' will be expected to pay up if it becomes necessary for her to call in the marker on them, and throw themselves on the spikes for the good of the Dear Leader and his Prosperity and Health Plan. 

Agreed

[ColonialMarine0431]

Don't count on that, the close vote in the House was a dance of carefully-staged pageantry, with Pope Nancy passing out the indulgences from a jealously-guarded and carefully-counted supply.  If it comes to it, some of the previous Dem 'Nays' will be expected to pay up if it becomes necessary for her to call in the marker on them, and throw themselves on the spikes for the good of the Dear Leader and his Prosperity and Health Plan. 

So prostitution is legal in D.C. now. Whodathunkit.

[bkg]

So prostitution is legal in D.C. now. Whodathunkit.

Been legal (or rather, not enforced) for years... It's a thriving industry...

[DefiantSix]

So prostitution is legal in D.C. now. Whodathunkit.

What?  Are you kidding?  DC's Capitol Hill is the site of the country's oldest continuously operational whorehouse.