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Karlis

Vote to Repeal Obamacare Passes 245-189

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Br Cornelius

Oh my apology then, I made an assumption you are an American leftist.

You may disagree with our Foreign Policies, but America do what they do because of the lesson of WWII.

Where are you from anyway?

I am British by birth and currently live in Ireland.

Ireland is currently undergoing a particularly brutal "bust" cycle which is implicit in Neoliberal economics. From personal experience (a number of times round starting with that b**** Margaret Thatcher - the most hated woman in Britain), I would much rather see a strong legislative control of markets - such that we can realise their advantages without experiencing the pain's of their excesses.

Br Cornelius

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Copasetic

Wait a minute?

There's actually repairs for hiatus hernias and the like?

Also, the sad thing about this is I get the impression that's it's far more about sticking it to Obama and the liberals more than it about being for the people who don't want it.

Sorry for not being specific. Hiatal hernias occur because of a weakening of the central tendon (part of the diaphragm) and involve the stomach's protrusion through the inferior thoracic aperture into the thorax. Generally this tends to be protrusion of the gastric fundus (the "hump-back" of the stomach) and generally can be alleviated by the aggravating factor (such as weight problems). In severe cases reduction of the fundus can be done through fundoplication or removal of some of the body of the stomach to decrease the size of the fundus along the greater curvature of the stomach.

The types of hernial repairs I was discussing above are for those that occur more south of the boarder, which is a protrusion of "guts" through the superficial inguinal ring, deep inguinal ring, obturator foramen, etc and generally involves reduction of the hernial sac and the use of superlative scaring by introduction of a irritating factor (mesh in this case) and its closure to the conjoint tendon.

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Br Cornelius

Sorry for not being specific. Hiatal hernias occur because of a weakening of the central tendon (part of the diaphragm) and involve the stomach's protrusion through the inferior thoracic aperture into the thorax. Generally this tends to be protrusion of the gastric fundus (the "hump-back" of the stomach) and generally can be alleviated by the aggravating factor (such as weight problems). In severe cases reduction of the fundus can be done through fundoplication or removal of some of the body of the stomach to decrease the size of the fundus along the greater curvature of the stomach.

The types of hernial repairs I was discussing above are for those that occur more south of the boarder, which is a protrusion of "guts" through the superficial inguinal ring, deep inguinal ring, obturator foramen, etc and generally involves reduction of the hernial sac and the use of superlative scaring by introduction of a irritating factor (mesh in this case) and its closure to the conjoint tendon.

Well said.

Br Cornelius

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Agent X

Sorry for not being specific. Hiatal hernias occur because of a weakening of the central tendon (part of the diaphragm) and involve the stomach's protrusion through the inferior thoracic aperture into the thorax. Generally this tends to be protrusion of the gastric fundus (the "hump-back" of the stomach) and generally can be alleviated by the aggravating factor (such as weight problems). In severe cases reduction of the fundus can be done through fundoplication or removal of some of the body of the stomach to decrease the size of the fundus along the greater curvature of the stomach.

The types of hernial repairs I was discussing above are for those that occur more south of the boarder, which is a protrusion of "guts" through the superficial inguinal ring, deep inguinal ring, obturator foramen, etc and generally involves reduction of the hernial sac and the use of superlative scaring by introduction of a irritating factor (mesh in this case) and its closure to the conjoint tendon.

Aha. Thanks.

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Harte

Illinois is not corrupt.

How's the weather up there in fantasy land? LOL

Harte

Edited by Harte

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preacherman76

Yes PM, we understand that to be your opinion that you are forwarding. I don't think anyone is confused on that point.

No, we've played these reindeer games before sir. You make wild ass claims about science and rather than force you to support your claims, I've patiently tried to educated you regarding the error inherit in them. You've failed to learn anything from prior conversations and they normally conclude with your disappearance from the topic. Time for the new and proper approach then, you made the claim--You need to support it. Not I. In doing so, you may learn a thing or two. You've decide we are fundamentally at odds and you're not going to take my word for it (good you shouldn't anyway, you should always verify information given to you--From authority or not). Ergo, I believe the best to educate you is to ask you what is asked of any claimant--That is support your position with researched, reasoned, evidence.

Here is the bottomline Doc (Im gonna call you Doc from now on :). There is no way you or anyone can justify charging someone 1000 dollars for a simple x-ray.

Do you mean aspirin? No, why would aspirin be different today than in 1965? The formulary change in aspirin happened around the turn of the 19th century. Changing it (salicylic acid) through acetylation. Of course even at this time it was expensive because it wasn't mass produced. Until mass production it remained a pricey substance, but once mass produced and heavily promoted as a 'cure-all' it was the most widely used drug in the world. It fell from the limelight with the advent of better analgesics but again regained popularity in the 60's and 70's because of its protective affects in clotting diseases (them mechanism later discovered showed how it worked on cyclooxygenases inhibiting pathways for prostaglandins and thromboxanes).

The price of aspirin depends on brand, other constituents of the tablet (such as the addition of caffeine) and market. Are you suggesting that the price of aspirin has risen because of the government? If so, you'll need to support that claim with evidence too. To help you out a bit, you could provide the adjusted price for various brands of aspirin from the 50's to today. Be sure to also indicate whether we are just talking about the drug (acetylsalicylic acid) or whether there are other active ingredient additives. Again, this would be the great kind of thing to show in graph form. Where you show us a graph of the dramatic increase in aspirin price that occurred post 1965 (as you claim) then you can propose your hypothesis of this increase, which again, you'd support with evidence.

A simple no would have been fine. Can you explain why it cost a insurance company 100 if given to someone in the emergency room?

Just to make sure you're not confused here, the 19th century refers to the 1800's. I was pointing out that end user medical costs have been rising since then, because of the advent of technological advancements achieved throughout the industrial and post-industrial revolution.

If you want to claim there was a dramatic spike at one point, you need to support that with evidence (again, great time for a graph) and as with the aspirin above--You then propose a hypothesis or explanation for that rise. First we need the observation though (the graph-esq material) then and only then do you propose an explanation for something. So please provide; the observation, your explanation of said observation, and corroborating evidence to support said explanation.

I did, link and everything.

I'm not sure where to start here. First it might help if you understood the term you were using (straw-man). Second, I'm not sure where you came up with the bit on MRIs.....Other than to suspect that once again your lack of knowledge is barring conversation. Are you under the impression that radiologists only read MRIs or something? You do realize they read all radiological imaging correct? You do realize that x-rays are radiological imaging correct? You also realize that different types of radiological imaging are used for different things--And some of those things are integral to providing a medical innervation the patient's life depends on? "Simple X-rays" included....

For example, suppose you showed up in the hospital with chest pain, a small pleural puncture along the midclavicular line, low BP, increased pulse etc. I would order a PA chest film (a simple x-ray) to see if the puncture had caused a tension pneumothorax which resulted in a mediastinal shift.

Point made. Even still like Ive said, my last ER visit cost 1500 bucks, for one simple x-ray,and 2 mins of a doctors time. It wouldnt cost anywhere near that, in any other country in the world. Capitalism has been highjacked in the medical field.

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Copasetic

Here is the bottomline Doc (Im gonna call you Doc from now on :). There is no way you or anyone can justify charging someone 1000 dollars for a simple x-ray.

Legally I'm required to tell you I am not yet licensed to practice medicine yet :lol: But you can call me doc for prior achievements if you really want :lol:

I suppose though (on to the serious business) that we'll have to agree to disagree. Everyone of course is entitled to their opinion and I can't force you too look into it.

A simple no would have been fine. Can you explain why it cost a insurance company 100 if given to someone in the emergency room?

Does it? The last time I was in the ER, I got way better drugs than that (mmmm narcotics) and sutures to match and they billed my insurance 300 I believe, almost all of that was for the price of the sutures as well.

I did, link and everything.

I'll dig back through and look.

Point made. Even still like Ive said, my last ER visit cost 1500 bucks, for one simple x-ray,and 2 mins of a doctors time. It wouldnt cost anywhere near that, in any other country in the world. Capitalism has been highjacked in the medical field.

Don't know homey, I'd have to see the services rendered portion of the bill to tell you. What kind of x-ray was it? What kind of doc? More than one doc? Was there discharge orders? Nurse time? Any other tests or procedures done? What was wrong?

Edited by Copasetic

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Blizno

I haven't read every post on this thread; there are too many.

In case it hasn't been said yet, uninsured individuals in USA cost the medical profession billions per year.

The uninsured typically wait until their health issues are desperate, then they go to emergency rooms.

The cost per hour of emergency room personnel and equipment dwarfs the cost per hour of a typical GP's office and staff.

If the uninsured could get regular checkups and could be treated early for even typical diseases, the cost for their care would be insignificant compared to several visits to emergency rooms after they get so sick that they need desperate care.

I've read several people here post of very high costs for basic services, such as X-rays.

Hospitals pass on the huge costs of uninsured people visiting emergency rooms as a last resort to those of us who have insurance.

If everybody had access to basic care, such as yearly physicals, the costs that hospitals have to pass on due to extremely expensive emergency room care for uninsured people wouldn't be incurred and the total cost of health care for everybody would drop greatly.

There's no excuse for a developed nation like USA to fail to provide universal health care to all of its citizens. The only reason USA is the last developed nation to provide universal health care is because certain ultra-wealthy individuals see a threat to their continued reaping of huge wealth from the present US private insurance system if USA joined the civilized world and provided universal care.

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preacherman76

Legally I'm required to tell you I am not yet licensed to practice medicine yet :lol: But you can call me doc for prior achievements if you really want :lol:

I suppose though (on to the serious business) that we'll have to agree to disagree. Everyone of course is entitled to their opinion and I can't force you too look into it.

I believe you are gonna finnish what you set out to do Doc. How long till its officail?

Does it? The last time I was in the ER, I got way better drugs than that (mmmm narcotics) and sutures to match and they billed my insurance 300 I believe, almost all of that was for the price of the sutures as well.

Yea man. I help my grandfather go over his bills from time to time. He went to the er with chest pains, and other signs of possible heart attack. So right away they gave him one. 100 bucks. I am in NY though, where a pack of smokes costs 11 dollars. So I cant say if thats the norm everywhere.

Don't know homey, I'd have to see the services rendered portion of the bill to tell you. What kind of x-ray was it? What kind of doc? More than one doc? Was there discharge orders? Nurse time? Any other tests or procedures done? What was wrong?

I found myself in a little car wreck one morning on the way to work. I had sleep apnea real bad,(self cured through serious life style changes over the last 6 months, plus a minor operation on my nose) and knotted off going 60. When I came too I found myself half way in the ditch on the OTHER side of the road. Long story short I displayed some serious driving skills in not flipping the car, but wasnt good enough to avoid the guard rail back on my side of the road. Anyhow, my left shoulder took all the impact. It still bothers me to this day.

It was the same kinda x-ray youd get for any broken or sprained bone. I dont know the technical name for it, but from my vast experiance with x-rays (former semi pro football player) it was as basic as you can get. I only saw one doctor, for 2 mins. One minute to send me to the x-ray, and one to write me a script, and tell me to follow up with my regular doctor. I dont know his qualifications. I spent about 3 minutes with a nurse, took blood pressure, and asked the typical questions. Grand total 1500 bucks. I was thanking God I had good insurance.

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preacherman76

I haven't read every post on this thread; there are too many.

In case it hasn't been said yet, uninsured individuals in USA cost the medical profession billions per year.

The uninsured typically wait until their health issues are desperate, then they go to emergency rooms.

The cost per hour of emergency room personnel and equipment dwarfs the cost per hour of a typical GP's office and staff.

If the uninsured could get regular checkups and could be treated early for even typical diseases, the cost for their care would be insignificant compared to several visits to emergency rooms after they get so sick that they need desperate care.

I've read several people here post of very high costs for basic services, such as X-rays.

Hospitals pass on the huge costs of uninsured people visiting emergency rooms as a last resort to those of us who have insurance.

If everybody had access to basic care, such as yearly physicals, the costs that hospitals have to pass on due to extremely expensive emergency room care for uninsured people wouldn't be incurred and the total cost of health care for everybody would drop greatly.

There's no excuse for a developed nation like USA to fail to provide universal health care to all of its citizens. The only reason USA is the last developed nation to provide universal health care is because certain ultra-wealthy individuals see a threat to their continued reaping of huge wealth from the present US private insurance system if USA joined the civilized world and provided universal care.

Hey Blizno (cool name :tu: )

First I totaly agree that people who cant pay thier medical bills Jacks up the prices for everyone. There is no arguing that. However, I totaly disagree that Universal coverage is the answer. I believe there are a few steps we can take that would lower the costs, without having to set up another giant federal program. People will tell you that universal care would lower the costs, but I cant think of a single government program, social or otherwise, that didnt end up costing 10 fold what was projected. They just cant handle the responcibility. Everything these people touch (Republican or democrate) ends up corupted an full of waste.

Here are just a few idea's to avoid another freedom grabbing social program. Most people dont know this, but each state only allows just a handful of insurance companies to operate in any given state. Some have as few as 2. This is a capitalism killer. They are able to form monopolies. Allow all insurance companies to operate in any state. Open competition. Another thing most people dont know, is that not for profit insurance companies are heavily restricted, and in many cases not allowed at all depending on the state. These restrictions must be removed. The one area I wouldnt mind the federal government getting involved in would be restricting drug company costs. But even thats impossible currently cause drug company lobbiests litteral own our government. Maybe a not for profit drug company wouldnt be out of order.

This would allow many people who currently cant afford insurance, to be able to do so. Some still wouldnt even if they could afford it, and would still be passing the buck to the rest of us. But I for one would rather deal with the consequences of freedom, then having to deal with government mandated tyranny.

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Copasetic

I believe you are gonna finnish what you set out to do Doc. How long till its officail?

3 years, 3 tests.

Yea man. I help my grandfather go over his bills from time to time. He went to the er with chest pains, and other signs of possible heart attack. So right away they gave him one. 100 bucks. I am in NY though, where a pack of smokes costs 11 dollars. So I cant say if thats the norm everywhere.

I found myself in a little car wreck one morning on the way to work. I had sleep apnea real bad,(self cured through serious life style changes over the last 6 months, plus a minor operation on my nose) and knotted off going 60. When I came too I found myself half way in the ditch on the OTHER side of the road. Long story short I displayed some serious driving skills in not flipping the car, but wasnt good enough to avoid the guard rail back on my side of the road. Anyhow, my left shoulder took all the impact. It still bothers me to this day.

It was the same kinda x-ray youd get for any broken or sprained bone. I dont know the technical name for it, but from my vast experiance with x-rays (former semi pro football player) it was as basic as you can get. I only saw one doctor, for 2 mins. One minute to send me to the x-ray, and one to write me a script, and tell me to follow up with my regular doctor. I dont know his qualifications. I spent about 3 minutes with a nurse, took blood pressure, and asked the typical questions. Grand total 1500 bucks. I was thanking God I had good insurance.

I'm not familiar with pricing in NY. I can tell you that the type of x-ray and many other factors go into play. People generally assume and x-ray, is an x-ray, is an x-ray. Which is not the case.

The area you get x-rayed, the number of radiograms they take and where you get it done will affect the cost greatly. A PA x-ray of the abdomen is not the same price as an AP of the thorax, or knee etc. The type of film they use matters, is it digital or hard film, what kind of hard film? Do copies need made? Do they need sent anywhere, etc? The number of views they need to take matter, did they shoot you 1 time? 3, 5, 11, etc? Are they comparing any of these to prior x-rays you had at the facility or in the network? Patients don't often realize that ERs have access to older x-rays they have had and that those can be brought up too for the staff to use in determining diagnostic factors--This of course, adds to the bill.

Whether the radiologist signed off on it matters. In your case it sounds like they did. Sounds like you saw an attending in either GP or emergency medicine. They work on the recommendations of radiologists who are 'behind the scenes' and you don't get to meet. But their job is reading and interpreting imaging and that comes with a hefty bill. Because they spend so much time learning human anatomy (13+ years) just having the radiology report attached means your bill could go up anywhere from 150-300 dollars for every hour the radiologist spends looking at it. What if the radiologist needs a consult from another in the rad department? Add in the cost of time for his attending as well. So that 45 minutes or an hour you spent waiting for the doc to come back? Your bill could have been run up dramatically.

It also makes a difference where you get it done. Emergency room imaging is much more expensive than out patient. In part, as someone else mentioned, of passing off the cost of the uninsured and in part because of the types of imaging equipment and repertoire/infrastructure that goes along with the more advanced (and emergent medical problem ready) imaging equipment they have.

Also, where in the country you are matters as well. As you point out, the cost of everything is greater in NY. Nationwide, radiologists have an average starting salary of $385,000. The high 75th percentile is $450,000, starting. After 4 or 5 years they can be making $654,278 (the 75th percentile again). I know these averages are higher on the east coast. Probably by a couple grand or 10.

Edit: Again realize though that is one guy, if they needed a consult from a specialist in rad (say a thoracic specialist, Musculoskeletal specialist or Neurorad specialist) then your bill would have been sky high, those guys that do fellowships, well lets just leave it at they make a damn lot.

Edited by Copasetic

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