Somebody FREAKIN shoot me!!!!

[GregWeld]

Originally Posted by realcoray

Ok so here's a question. Let's say they come to an agreement before the end of the year. Let's say it has revenue and cuts in the ballpark of halfway in between what the first offers were, in the range of 2 trillion, probably 1.2 revenue, 800 cuts. Clearly not the silver bullet to the deficit but a start and just generally calms everyone down.

Next year, let's say they negotiate tax reform and vastly simplify the tax system. This is widely anticipated as both sides want to do it although of course they differ on the details, but let's again assume it ends up balanced. The expectation is most rates would drop except capital gains which may increase, but it's way early to say.

All of that happens, does your view of the president change at all? Take all of your ideas about what you think would fix things, like a flat tax and realistically look at what can be accomplished, and what would at least qualify as him doing a satisfactory job?

That would qualify handily in my book! Then if "they" would modify Obamacare to create some cost controls in healthcare....he'd be the guy I voted for in 2008.

[realcoray]

Originally Posted by GregWeld

That would qualify handily in my book! Then if "they" would modify Obamacare to create some cost controls in healthcare....he'd be the guy I voted for in 2008.

What sort of cost controls?

You know I work in a business related to health care and the fascinating thing that I've learned since being exposed to it is how very dependent health care providers are on government help.

Here's an example. If you are a health care provider, the government will pay you 44k to adopt electronic health records and demonstrate you're using them. That's 44k PER doctor. The software to do that is not cheap but many facilities profit from the program.

Now, in a year or two, if you haven't switched over the government will start to penalize you. Now, how can they do that, that encourages people to switch? Cut medicare payments by 1%. It goes up from there, but a 1% cut in medicare payment is a legitimate incentive to these places to sometimes spend millions of dollars to be ready to avoid not getting that 1%.

In essence, any tweak at all to medicare reimbursements causes doctors to not be pleased.

A major source of cost increases is useless tests and imaging that occurs. Everyone who bonks their head, demands a MRI and hospitals LOVE that because while the machines do cost millions, it's a huge profit center for them.

The difficulty here is who can step in and question the need for the MRI. You don't want your insurance being a dick when you legitimately need one, and the hospital is unlikely to police themselves, in particularly with a procedure with nearly no risk of being sued and some risk of being sued if you miss something.

Of course being sued is part of the cost of health care and should probably be looked at, but you have to balance things out. On one hand everyone makes mistakes but a doctors mistakes can mean your family member died. They should probably be capped or some sort of sliding scale of awards, I'm not sure. I can say that the doctors most likely to be sued for malpractice, make the most money to compensate for that.