Comments on: Dean Ornish injects himself in the health reform debate http://www.kevinmd.com/blog/2009/09/dean-ornish-injects-health-reform-debate.html Wed, 15 Feb 2012 00:05:00 +0000 hourly 1 By: Mikehttp://www.kevinmd.com/blog/2009/09/dean-ornish-injects-health-reform-debate.html#comment-111953 Mike Tue, 15 Sep 2009 21:35:17 +0000 http://www.kevinmd.com/blog/?p=40074#comment-111953 People go to the doctor when they are sick. Even if it was free, most wouldn't go.I'll say it again: PRIMARY CARE VISITS ARE CHEAP!!! Its the shots/meds/labs that cost all the money. And guess what: DOCTORS CAN'T CONTROL THOSE COSTS!!!.When people finally say to LabCorp or Quest "You can only charge such and such", or when the government says "Pfizer must compete with WalMArt" then you will have affordable health care. Is that socialist? I don't think so .I think the system we have NOW is very anti-capitalist. Basically, taxpayers support major corporations, so you can't get more socialized than that. It would just be nice not to get ripped off. People go to the doctor when they are sick. Even if it was free, most wouldn’t go.

I’ll say it again: PRIMARY CARE VISITS ARE CHEAP!!! Its the shots/meds/labs that cost all the money. And guess what: DOCTORS CAN’T CONTROL THOSE COSTS!!!.

When people finally say to LabCorp or Quest “You can only charge such and such”, or when the government says “Pfizer must compete with WalMArt” then you will have affordable health care. Is that socialist? I don’t think so .I think the system we have NOW is very anti-capitalist. Basically, taxpayers support major corporations, so you can’t get more socialized than that. It would just be nice not to get ripped off.

]]> By: Donald Green MDhttp://www.kevinmd.com/blog/2009/09/dean-ornish-injects-health-reform-debate.html#comment-111880 Donald Green MD Tue, 15 Sep 2009 10:36:04 +0000 http://www.kevinmd.com/blog/?p=40074#comment-111880 If it is catastrophic insurance you are looking for then Medicare is the model. Everyone who pays in gets Part A, coverage for hospital and expensive ancillary treatments. All the rest is elective and need not be chosen and can be bought in the private market. Part B is for doctor visits and comes with a sliding scale premium. This still requires further insurance to fill in the gaps. Part C is Medicare HMOs (Medicare Advantage) and is run by private insurers. Unfortunately this is done at 130% on average greater than regular Medicare. Part D is the prescription package, underfunded and therefore in deficit. This too is run solely by private companies and has been a financial disaster for patients with high medication costs. So we do not have to go back to anything. We are already there and the parts that need fixing are the unconscionable cost overruns of the private sector. This wishing to go backwards to some more ideal spot has no foundation. It will not solve the problems we face, namely, millions of uninsured, medical bankruptcy, and thousands of lives lost each year. If you tell me it is not your problem, this is shooting yourself in the foot. A more efficient payment system coupled with improved coordinated care will put more jingle in your pocket, not remove it. It will also lessen government's involvement in your life. The present system is leaving many of our citizens out in cold and government is left to pick up the pieces. Not only is it wrong, it is unwise.Dr. Ornish has not given an alternative view of a doctor's routines. There is no stopping any Medicare patient from having routine care and, if healthy, it will be a one time yearly fee out of their pocket. It would be nice to have it paid for but not a major necessity. If a patient has a diagnosis it is no longer routine and Medicare pays. The latter is usually the case. This age group does not usually escape some ailment. Further an overwhelming number of physicians, close to 70%, now favor some kind of Medicare solution for all. This was from the most recent NEJOM sponsored by the Robertt Wood Johnson foundation. If it is catastrophic insurance you are looking for then Medicare is the model. Everyone who pays in gets Part A, coverage for hospital and expensive ancillary treatments. All the rest is elective and need not be chosen and can be bought in the private market. Part B is for doctor visits and comes with a sliding scale premium. This still requires further insurance to fill in the gaps. Part C is Medicare HMOs (Medicare Advantage) and is run by private insurers. Unfortunately this is done at 130% on average greater than regular Medicare. Part D is the prescription package, underfunded and therefore in deficit. This too is run solely by private companies and has been a financial disaster for patients with high medication costs. So we do not have to go back to anything. We are already there and the parts that need fixing are the unconscionable cost overruns of the private sector. This wishing to go backwards to some more ideal spot has no foundation. It will not solve the problems we face, namely, millions of uninsured, medical bankruptcy, and thousands of lives lost each year. If you tell me it is not your problem, this is shooting yourself in the foot. A more efficient payment system coupled with improved coordinated care will put more jingle in your pocket, not remove it. It will also lessen government’s involvement in your life. The present system is leaving many of our citizens out in cold and government is left to pick up the pieces. Not only is it wrong, it is unwise.

Dr. Ornish has not given an alternative view of a doctor’s routines. There is no stopping any Medicare patient from having routine care and, if healthy, it will be a one time yearly fee out of their pocket. It would be nice to have it paid for but not a major necessity. If a patient has a diagnosis it is no longer routine and Medicare pays. The latter is usually the case. This age group does not usually escape some ailment. Further an overwhelming number of physicians, close to 70%, now favor some kind of Medicare solution for all. This was from the most recent NEJOM sponsored by the Robertt Wood Johnson foundation.

]]> By: jsmithhttp://www.kevinmd.com/blog/2009/09/dean-ornish-injects-health-reform-debate.html#comment-111878 jsmith Tue, 15 Sep 2009 05:16:40 +0000 http://www.kevinmd.com/blog/?p=40074#comment-111878 There is an assumption in current political discourse that personal responsibility and good health habits will make people healthier and thus lower medical expenditures for society. Unfortunately this assumption is not proven and might very well be wrong. Good health habits can lead to longer lives and more money spent on health care over that longer life . See Rappange et al J Pulic Health http://jpubhealth.oxfordjournals.org/cgi/content/abstract/fdp079v1that longer life. Don't get me wrong. I'm all for healthy lifestyles, but I don't think they'll save us much money, if any. There is an assumption in current political discourse that personal responsibility and good health habits will make people healthier and thus lower medical expenditures for society. Unfortunately this assumption is not proven and might very well be wrong. Good health habits can lead to longer lives and more money spent on health care over that longer life . See Rappange et al J Pulic Health http://jpubhealth.oxfordjournals.org/cgi/content/abstract/fdp079v1that longer life.
Don’t get me wrong. I’m all for healthy lifestyles, but I don’t think they’ll save us much money, if any.

]]> By: Dr. Valhttp://www.kevinmd.com/blog/2009/09/dean-ornish-injects-health-reform-debate.html#comment-111871 Dr. Val Tue, 15 Sep 2009 01:30:07 +0000 http://www.kevinmd.com/blog/?p=40074#comment-111871 We need a well functioning sick-care system - but we must keep most people from needing it most of the time to insure solvency. And that requires a national commitment to lifestyle modifications - and a recognition that 80% of chronic diseases are preventable. The NHLBI recommends 5-10% total weight loss/obese individual to achieve major health improvements. That's not unattainable. We're not aiming for us all to look like Kate Moss, we're aiming for weight reduction from 200lbs to 190lbs. We need a well functioning sick-care system – but we must keep most people from needing it most of the time to insure solvency. And that requires a national commitment to lifestyle modifications – and a recognition that 80% of chronic diseases are preventable. The NHLBI recommends 5-10% total weight loss/obese individual to achieve major health improvements. That’s not unattainable. We’re not aiming for us all to look like Kate Moss, we’re aiming for weight reduction from 200lbs to 190lbs.

]]> By: Evinxhttp://www.kevinmd.com/blog/2009/09/dean-ornish-injects-health-reform-debate.html#comment-111861 Evinx Mon, 14 Sep 2009 21:44:03 +0000 http://www.kevinmd.com/blog/?p=40074#comment-111861 Yes, we need health insurance to cover major illnesses - but at present (thanks to the unintended consequences of a post WWII decision bcs of price controls) we ended up with a prepaid medical care system. We need to go back to a system of insurance for the expensive and unexpected - just like homeowners, auto, etc. Yes, we need health insurance to cover major illnesses – but at present (thanks to the unintended consequences of a post WWII decision bcs of price controls) we ended up with a prepaid medical care system. We need to go back to a system of insurance for the expensive and unexpected – just like homeowners, auto, etc.

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