INTRODUCTION TO THE BLOG "THE WORLD'S TERTULIA"
Let’s begin by defining the term tertulia: La Tertulia is a term originated in Spain (my birth place), which means "a gathering" "a group". Originally in Spain these groups of like minded people met in bars, or home and mostly discuss literature or art. Later it evolved to other times of discussion. In the 1960s, I belonged to such a group in Madrid name and we met in a cafe bar near of the "Gran Via “or in one of our member’s homes. The topic for discussion was announced one week prior to the meeting and the discussion lasted around 1 to 2 hours over coffee and brandy.
I do not know exactly how to start, but "the tertulia" evolves as members join and topics are discussed. I would like to pick up a topic and discuss it for a yet undetermined period of time, a week, a month... (depending on how many member join"
The first topic "The Health Care Debate in the US" to include anything related to the current health care, the "ideal health care" and the passed "Health Care Reform" While criticism is expected I would like the discussion to be imminently creational. Everyone has thoughts of what it wrong with the system, but I like to hear more about comprehensive solutions
In a few days if no one starts the discussion, I will
For the time being, I would not mind ideas as to how to conduct this blog
Juan L. Granados, June 4, 2010
PS. If you are interested in my profile you can find me in face book under Juan Granados
Well, I for one have many different thoughts on this. Working in the health care field for many years on the administrative end I can honestly say that I am not for the Medical Assistance Program as it stands. Far too many people have medical assistance handed to them when they are working and in my honest opinion, should be able to pay "somthing" toward theirs and their children's health care coverage. This entitlement that they feel extends to them not even feeling that they need to be responsible to obtain insurance referrals from their primary care physicians for appointments, cancelling appointment that they know they won't be able to keep, etc. If they had to at least pay a small token potion of their insurance it would mean that other taxpayers would pay less toward this in the form of taxes. Additionally, being the mother of a young adult who is one of "the working poor" who works 2 part time jobs and has no insurance coverage offered through her employment I do think there should be some affordable options for health care and dental coverage perhaps based on a sliding scale. Very few clinics offer this option so perhaps there could be an insurance plan somehow that would offer basic coverage such as one complete physical, one GYN and one to two dental visits each year as well as emergency care. I also think that the Medical Assistance reimbursement for services provided by physicians is deplorable. The reimbursement rate for which the physicians are paid for services rendered is ridiculous. Because the ratio in most hospitals of medical assistance payers to commercial insurance payers is exponentially higher, the physicians and hence the departments and divisions they work in often are in the red due in part of course to the slow and contractural reimbursement rate of the commercial and hmo insurances but mostly due to the ridiculous reimbursement rate by Medical Assistance. For example, one of our pediatric patients has a bilateral inguinal hernia repair. The billed surgeons portion of this fee is $1460. The actual reimbursement is $285! Really? No wonder there is such a drop off in the number of medical students in the teaching institutions now- how in the world can they ever expect to pay back their medical school loans when they are working for very little reimbursement for their institutions which translates into much smaller salaries? I am just saying.......
ReplyDeleteI agree that people who are working should not just be handed medical assistance either, but I also think that most employers should offer their employees health coverage. That said, I used to think that Canada's healthcare model had some merit to it. Now that I have a friend with 5 children who lives in Canada, one of which definitely suffers from some emotional and addiction issues, and I see how hard it is for her to get appointments with specialists, how long the wait is, how long they wait in the clinics, and how little covered psychiatric options they seem to have, I am very disappointed.
ReplyDeleteI think our healthcare reform may be great for people who haven't been offered health coverage through their employers, but I am scared for the rest of us who do have coverage that premiums will skyrocket, or worse, that our coverage (mine is pretty good!) will cease to exist if our employer thinks it will save them money for their bottom line.
I examine my Explanation of Benefits everytime they come in the mail, and I too am appalled at the amount that the insurance companies actually reimburse. Who determines what the dollar amount is that should be reimbursed???
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ReplyDeleteRobin. You make very good poits. Having patients on Medicaid pay a small amount for their visits and procedures (based on a sliding scale)will improve utilization of the services (patients will think twice about goig to the emergency room for a non-emergency problem if they have to pay a certain amount) Encouraging to keep apointments by charging something for missed appointme,is also a reasonable.As more and more people join Medicaid a systems of inducements for keepink appointments, losing weight, etc may make the system more cost efficient
ReplyDeleteKeep commenting
Juan
June 12, 2010 7:39 AM
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Jacksmom:
ReplyDeleteThank you for your comments. The amount paid to physicians for a given service is determined by the Insurance company, which by methods not disclosed determined “the usual and customary fee” for a given service. The interesting part is different practices get different reimbursement
The subject of socialize Medicine is a fascinating subject. I will, in the near future, write something about ists advantages and disadvantages
Keep commenting
Juan