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Kommienzuspadt posted:For what it's worth, working at the VA is also kind of like practicing medicine in 1995 The VA has had a federal mandate to use EMRs for...I dunno. At least 20+ years? It's EMR - VistA - while old, has the highest physician satisfaction of any EMR system. So....yeah. There are plenty of issues with the VA. No need to invent ones.
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Aug 10, 2018 02:17
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Zauper posted:It's EMR - VistA - while old, has the highest physician satisfaction of any EMR system. VistA has the honor of having by far the least intelligible source code I've ever seen in a shipping product.
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Aug 10, 2018 20:44
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cowtown posted:VistA has the honor of having by far the least intelligible source code I've ever seen in a shipping product. What the christ. 
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Aug 10, 2018 21:30
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Man I thought I wrote bad code.
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Aug 11, 2018 04:21
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cowtown posted:VistA has the honor of having by far the least intelligible source code I've ever seen in a shipping product. Mumps is used by a huge number of ehr's out there.
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Aug 11, 2018 04:39
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Yeah, Epic uses the same for the database end.
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Aug 11, 2018 07:21
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Seyser Koze posted:Yeah, Epic uses the same for the database end. Ya, as a former epic thrall, see my title text
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Aug 23, 2018 04:32
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So... With McCain seat replaced by a Trump loyalist any chance Obama care repeal will be resurrected before midterms
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Aug 27, 2018 03:32
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Mokelumne Trekka posted:. Republicns Not as long as Collins and Murkowski still vote no(Republicans have lost one of the Alabama seats since then)
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Aug 27, 2018 03:48
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Mokelumne Trekka posted:So... With McCain seat replaced by a Trump loyalist any chance Obama care repeal will be resurrected before midterms The answer is always yes. The GOP will always continue any attack to drag us backwards. It is literally why they exist. It's what they live for. Paul Ryan drank beer as a young man while dreaming of undoing extraordinarily successful legislation from the motherfucking 1930s. They are awful, ghoulish people.
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Aug 27, 2018 05:07
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LeeMajors posted:The answer is always yes. The GOP will always continue any attack to drag us backwards. It is literally why they exist. It's what they live for. Paul Ryan drank beer as a young man while dreaming of undoing extraordinarily successful legislation from the motherfucking 1930s. Out of curiosity: what legislation is that?
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Aug 27, 2018 07:18
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Aumanor posted:Out of curiosity: what legislation is that? Might be wrong but I seem to recall it was basically all of the New Deal.
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Aug 27, 2018 07:42
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Lemniscate Blue posted:Might be wrong but I seem to recall it was basically all of the New Deal. It didnt include black people so it shouldn't have been passed at all.
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Aug 27, 2018 11:53
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Aumanor posted:Out of curiosity: what legislation is that? Social Security. Ryan has said in interviews that he was "a politics nerd" in college and spent "days in the dorm room thinking about social security reforms" and the national debt.
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Aug 27, 2018 14:13
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Leon Trotsky 2012 posted:Social Security. As he himself was receiving social security checks making it possible for him to even pursue a career in politics.
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Aug 27, 2018 22:43
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the basic point is right but the specific quote ryan had was fantasizing about block-granting medicaid which gives you the idea of what kind of insufferable nerd he was in college
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Aug 27, 2018 22:56
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Raldikuk posted:As he himself was receiving social security checks making it possible for him to even pursue a career in politics. So does that mean that if Republicans give all the Social Security money to themselves and other rich people they can't be politicians anymore? Might actually be a worthwhile buyout! (I kid, most of our government expenditures already go to the ultra wealthy and very rich)
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Aug 27, 2018 23:02
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Stickman posted:(I kid, most of our government expenditures already go to the ultra wealthy and very rich) Calling tax benefits which provide the biggest benefit to the wealthy 'expenditures' is a little disingenuous. You could declare any sort of revenue generated by a private company or individual not collected as taxes as 'expenditures' if you were so ideologically inclined. Rich people still pay almost all of the income taxes, as they should, even after greatly benefiting from the mortgage interest deduction, lower marginal capital gains & dividend rates, SALT deductions, etc. Just say that you think that rich people should be taxed more.
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Aug 28, 2018 03:34
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I don't care if these assholes are rich or not, they should be taxed into poverty. https://twitter.com/libbycwatson/status/1034249883740463104?s=21 https://twitter.com/libbycwatson/status/1034251394017112064?s=21 https://twitter.com/libbycwatson/status/1034254294017560578?s=21
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Aug 28, 2018 03:53
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Cafepharma is just an anon rumor and poo poo starting forum. Think how many people work in commercial / sales at a company the size of Pfizer or Amgen and then look at the post counts. It's not a representative sample of the industry.
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Aug 28, 2018 04:12
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KingNastidon posted:Cafepharma is just an anon rumor and poo poo starting forum. Think how many people work in commercial / sales at a company the size of Pfizer or Amgen and then look at the post counts. It's not a representative sample of the industry. Moreover, CafePharma is literally the shittiest poo poo in the entire industry. Nothing worthwhile has ever been posted there, ever. The real gems were at BioFind, but that site's long gone. 
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Aug 28, 2018 15:22
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silence_kit posted:Calling tax benefits which provide the biggest benefit to the wealthy 'expenditures' is a little disingenuous. silence_kit posted:You could declare any sort of revenue generated by a private company or individual not collected as taxes as 'expenditures' if you were so ideologically inclined. silence_kit posted:Rich people still pay almost all of the income taxes, as they should, even after greatly benefiting from the mortgage interest deduction, lower marginal capital gains & dividend rates, SALT deductions, etc. Just say that you think that rich people should be taxed more. qq the people who have all the money get sad when their government welfare checks are called welfare rather than "earned money"  If they hate paying most of the taxes maybe they should stop hoarding most of the wealth.
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Aug 28, 2018 16:45
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silence_kit posted:Calling tax benefits which provide the biggest benefit to the wealthy 'expenditures' is a little disingenuous. You could declare any sort of revenue generated by a private company or individual not collected as taxes as 'expenditures' if you were so ideologically inclined. Tax expenditures aren't just a function of income, though - they're targeted reductions in tax liability (or credits) that are designed to promote or facilitate certain behaviors. They are functionally equivalent to direct payments, but reduce the logistics. Deductions and exclusions designed to accurately count income, like the employee income reduction. For instance, take the exemption for employee-sponsored medical insurance contributions (the largest expenditure, estimated to be ~$235 billion for FY2018). That's functionally equivalent to $235 billion* in direct spending to support the employer insurance mandate - public funding that goes to employers for the privilege of choosing what (now subsidized) insurance options their employees get, and then directly to insurance companies. Back when the corporate tax rate was progressive, this used to lead to regressive disbursement, too, since companies with smaller tax liabilities would receive a smaller effective per-employee disbursement. Now that the corporate taxes are flat, that's no longer true, at least until post a loss and then have to wait until your next posted profit for the effective disbursement. The other programs you mentioned are similar - mortgage interest deductions are designed to promote home ownership (well, "ownership"), and effective disbursements flow through the middle class to mortgage companies and home sellers. Differential tax rates for capital gains & dividends are effectively a direct subsidy on investments over other types of income (and because of progressive tax rates, it's a regressive subsidy in terms of disbursement per investment dollar earned). SALT deductions are designed to promote taxes and spending by local and state governments (except it turns out blue states use this to provide services, so gently caress you blue states). You do have a point, tax expenditures are all relative to tax liability in our progressive tax system (though the totality of the tax system is significantly less progressive). However, they are functionally equivalent to disbursements in control, targeting, and effect, so unless you're willing to call all disbursements and benefits for people with net-positive income "tax adjustments", it makes much more sense to consider them as government expenditures . *As an aside more relevant to the thread, if you throw that together with Medicaid and Medicare spending ($1.25 trillion), you get $1.5 trillion in government subsidies for healthcare, which is already over Canada's $1.1 billion in government spending for their universal system (adjusted to US population and USD). And that's before all the other types of government health spending in the US, such as our defacto insurance system for the uninsured poor (propping up hospitals with ERs required to take patients regardless of ability to pay).
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Aug 28, 2018 16:46
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For anyone who's read the story of an insured teacher who got stuck with a $108,951 hospital bill after a heart attack, there's been a resolution:quote:Editor's note: Shortly after this story by Kaiser Health News and NPR was published and broadcast on Monday, St. David's said it was now willing to accept $782.29 to resolve the $108,951 balance because Drew Calver qualifies for its "financial assistance discount." In a statement, the hospital said this offer was contingent on Calver submitting his application for a discount based on his household finances. Calver disputed that he owes any additional money to St. David's and said this situation should have been resolved long before now. Amazing how some terrible publicity can magically reduce a totally legitimate hospital bill by over 99%!
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Aug 28, 2018 17:08
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Rhesus Pieces posted:For anyone who's read the story of an insured teacher who got stuck with a $108,951 hospital bill after a heart attack, there's been a resolution: But they didn't say they would actually do that? They said he could apply for it?
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Aug 28, 2018 17:15
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hobbesmaster posted:But they didn't say they would actually do that? They said he could apply for it? Yeah, sounds like a cut and dried delaying tactic by the hospital to get out of the news and when they deny the application they get to be all "too many assets/income to qualify and is therefore responsible for the balance".
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Aug 28, 2018 17:47
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HCA is a garbage provider system. I'm pretty sure most major insurers cut them out of their networks in the last couple years.
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Aug 28, 2018 18:01
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and therefore to make the money back they charge the remaining insurers more, and to make that money back they charge the hospitals more, and the grand system continues unabated
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Aug 28, 2018 18:07
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Stickman posted:And that's before all the other types of government health spending in the US, such as our defacto insurance system for the uninsured poor (propping up hospitals with ERs required to take patients regardless of ability to pay). That's called Medicare, just FYI. Don't need to count it twice. DSH payments are part of Medicare.
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Aug 28, 2018 18:31
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baquerd posted:Yeah, sounds like a cut and dried delaying tactic by the hospital to get out of the news and when they deny the application they get to be all "too many assets/income to qualify and is therefore responsible for the balance". Best part is in the article they’re outright accused of fraud.
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Aug 28, 2018 18:33
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Zauper posted:That's called Medicare, just FYI. Don't need to count it twice. DSH payments are part of Medicare. Thanks! I didn't realize that was under the Medicare umbrella. VVVV The Congressional Budget Office and Department of the Treasury: noted sophists that just "want to tax rich people more". VVVV Stickman fucked around with this message at 22:13 on Aug 28, 2018 |
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Aug 28, 2018 19:24
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VitalSigns posted:No it does not follow that you must treat anything less than a 100% tax rate as an expenditure. It is perfectly consistent to define a tax expenditure as "any reduction of one taxpayer's effective tax rate with respect to another taxpayer having equal income" Stickman posted:You do have a point, tax expenditures are all relative to tax liability in our progressive tax system (though the totality of the tax system is significantly less progressive). However, they are functionally equivalent to disbursements in control, targeting, and effect, so unless you're willing to call all disbursements and benefits for people with net-positive income "tax adjustments", it makes much more sense to consider them as government expenditures. These definitions of ‘expenditure’ are sophistic and convoluted, just like defining any potential tax, which could be collected by the government but currently isn’t, as an expenditure. Just say that you want to tax rich people more!
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Aug 28, 2018 19:40
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Reik posted:HCA is a garbage provider system. I'm pretty sure most major insurers cut them out of their networks in the last couple years. That's not at the heart of the matter, though: It's balance billing, part of the new normal that accompanies a system of ultra-narrow networks: quote:Despite the surprise, Calver asked from his hospital bed whether his health insurance would cover all of this, a financial worry that accompanies nearly every American hospital stay. He was concerned because St. David's is out-of-network on his school district health plan. The hospital told him not to worry and that they would accept his insurance, Calver said. "Several" states = handful of those outlawing balance billing--and even in that case, there are loopholes, like the one above. Balance billing is outlawed at the federal level for people insured under Medicare. The same should be true for all insureds, whether under an Obamacare plan, an employer's self-insurance plan, or an employer's standard group plan. At least outlaw it in emergency situations, in which one doesn't have the opportunity to consent to out-of-network care at an in-network facility. eta: It does seem as if the hospital "overcharged" the patient, as hospitals are wont to do--but that's a logical consequence of the regulatory captured ACA, which didn't set cost limits on providers, insurance premiums, or pharma. etaa: Love the kicker to that story, which is pretty much  personified:quote:With any of these entities, you can always appeal to reason, with this argument: You had no choice but to go to an out-of-network hospital in the case of a life-threatening emergency, so the insurer and the hospital should work out payment and hold you harmless from financially crippling bills. "should" lol. As if the hospital isn't gonna send your rear end to collections & destroy your credit rating before you can file an appeal with your private insurer. Willa Rogers fucked around with this message at 20:28 on Aug 28, 2018 |
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Aug 28, 2018 20:18
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Willa Rogers posted:That's not at the heart of the matter, though: It's balance billing, part of the new normal that accompanies a system of ultra-narrow networks: The law that says that insurers have to pay in-network benefits for all emergency room visits has a ton of negative side-affects, one of them being increased balance billing. Forcing insurance providers to pay at the in-network benefit level does not also force the providers to agree to the contractual provisions that are normally included in these contracts, one of which is prohibiting balance billing. In Texas specifically this law has lead to a dramatic increase in the number of freestanding ERs, which have no incentive to contract with insurers due to them being paid at in-network benefit which means they will balance bill anyone that visits them. A much better solution would be any ER visit at a non-contracted provider would pay a fixed percent of the Medicare reimbursement. Insurers will still want to contract with hospitals due to negotiated rates on all of the non-ER care, and the hospital will try to negotiate a higher rate for their ER care. Freestanding ERs that can show a proof of need in their area can be reimbursed at a higher rate. Reik fucked around with this message at 21:27 on Aug 28, 2018 |
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Aug 28, 2018 21:23
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silence_kit posted:These definitions of ‘expenditure’ are sophistic and convoluted, just like defining any potential tax, which could be collected by the government but currently isn’t, as an expenditure. These are not equivalent, it's already been explained to you why in exact detail, unless you can do better than "nuh-uh" I think we're done here.
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Aug 28, 2018 21:38
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Do any of you have experience ordering drugs from Mexico or Canada? Any reputable (lol) sites? I need amoxicillin if that helps with a recommendation.
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Aug 29, 2018 23:10
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Arrgytehpirate posted:I need amoxicillin if that helps with a recommendation.
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Aug 29, 2018 23:21
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Ravenfood posted:Based on what I have a sinus and/or ear infection. Thick yellow and green mucus that smells bad. My left ear won’t pop and alternates between a dull ache and a sharp stab. I have a small fever that gets better when I sleep and then picks up throughout the day. And I’ve had them before and the symptoms are the same so, based on uh, experience I guess.
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Aug 29, 2018 23:33
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Arrgytehpirate posted:Do any of you have experience ordering drugs from Mexico or Canada? Any reputable (lol) sites? This part of the forums seem unlikely to bear fruit in terms of actual assistance. You'd probably have a better shot in the medical forum, The Goon Doctor.
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Aug 30, 2018 00:16
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Arrgytehpirate posted:I have a sinus and/or ear infection. Thick yellow and green mucus that smells bad. My left ear won’t pop and alternates between a dull ache and a sharp stab. I have a small fever that gets better when I sleep and then picks up throughout the day. Isn’t that as likely to be viral or fungal which would require either no other other treatment?
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Aug 30, 2018 00:16
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