Health Care Reform

[Borysko]

I've noticed there's very little discussion of Health Care Reform here in the U.S. on Optiboard, which is beyond odd considering we all work in the health-care field.
Frankly, I think the lack of discussion is due to the fact that any political discussion might get heated, and we all know now that bannings and heavy-handed modding are par for the course here. Heck, mentioning Health Care Reform might result in an instant ban, it wouldn't shock me.
I support reform and a public option, and I'd love to hear more from OD's and working opticians on the subject. It's very strange to me that it's not the hottest topic here.
I'll bet I get banned or at least warned for posting this.

[For-Life]

I tend to agree with you that I think it is such a heated item that people do not want to touch it.

I also think that when we have discussed it, that people are tending to push more Conservative versus Liberal, instead of talking about the facts. By I do not blame them, since this is what the politicians are doing

[fjpod]

I think our English has improved a lot, Borysko...seriously, though, I too support HCR and a public option.

One of the problems with our current health insurance system is, it is not mandatory for everyone to get it. Very often younger, healthier individuals will forego it for some other work benefit, or maybe it is not available at all in the workplace...but at the first sign of serious illness, everyone wants to sign-up. It's like getting into a car accident and trying to buy collision insurance after the fact. Everyone needs to pay in (even if it is some small amount for those in need), in order to have the benefit later when they may need it.

Years ago, you could blame doctors and hospitals for running up the cost of health care...but today, insurance companies are in the business of making corporate profits to show on their bottom lines, to please shareholders. Sometimes...(not all the time) capitalism may not be the best thing.

No system will be perfect. And it's got nothing to do with socialism, communism, etc. What's social security? What's a federal income tax? What is a local school tax? They're all forms of socialism.

[FVCCHRIS]

I think our English has improved a lot, Borysko...seriously, though, I too support HCR and a public option.

One of the problems with our current health insurance system is, it is not mandatory for everyone to get it. Very often younger, healthier individuals will forego it for some other work benefit, or maybe it is not available at all in the workplace...but at the first sign of serious illness, everyone wants to sign-up. It's like getting into a car accident and trying to buy collision insurance after the fact. Everyone needs to pay in (even if it is some small amount for those in need), in order to have the benefit later when they may need it.

Years ago, you could blame doctors and hospitals for running up the cost of health care...but today, insurance companies are in the business of making corporate profits to show on their bottom lines, to please shareholders. Sometimes...(not all the time) capitalism may not be the best thing.

No system will be perfect. And it's got nothing to do with socialism, communism, etc. What's social security? What's a federal income tax? What is a local school tax? They're all forms of socialism.

I think that a public option is necessary. Too many people are getting caught up in the whole "your plan vs. our plan" debate. We all need to remember how the push for controlling health care costs came about. Basically the present system fails a huge part of our population here in America. We cannot be a great nation if we allow the "lower income" citizens to die for lack of proper care. :finger:

On a personal note consider my own families situation in the past two years: I am extremely lucky to work for an O.D. here who pays over $1000 a month out of his own pocket for a good PPO plan for me, my wife and 3 kids. It was one of the reasons I moved a thousand miles to nail this job down. My son made two trips to the hospital in one year(diabetic) and my wife had cancer surgery the same year. Just the deductibles and out of pocket expenses for Dr. visits, lab stuff, ambulance and surgery alone were enough to trigger a financial disaster for us. No equity left in the house and the Dr's and hospitals-- who initially told me not to worry about the expenses right now-lets just get you well! Well they certainly wasted no time trying to sue me for 20K worth of "uncovered" expenses we had no way of paying. Medical care in this country should not take away everything you spent a lifetime building, like your home and your credit rating. Public option??? Hell yes. I'll pay a higher tax each year if it lets me sleep at night knowing I don't have to trade my families health for my lifes work.:)

[Crazy-bout-Optics]

From what I am aware of most forms of socialized medicine, and thats what is is, no matter how you cut it, does not pay for Glasses. If they do, such as in Medicare, what is paid out to the Dr and given as "free" to the Pt is minimal at best. Being that we are a great Capitalist society, I don't think the average American would except in eyewear what the Government would like to give them.

Currently we have people with Medicare (Socialized Medicine) that also have a separate (private) vision plan. I don't think it will be any different under a Socialized plan here in the US, as I can't see the government paying for the Chanel, and Gucci frames that the patients will actually want and not the "BC" glasses that would be provided for "free" even though we all know that "free" in this case is not actually "free."

If anything I could potentially see a Socialized plan that favors OMD over OD, since they are after all "real" doctors, as the general public would probably perceive them to be anyway (Not my personal opinion).

While Capitalism is generally the least evil of all options, it is GREED that has gotten us to where we are today. When you switch from a private pay system to a "free" socialized plan what we will see is an abuse of the system.

What I mean by this is when people have to actually pay $$$ out of pocket for services and goods, they see value in it and make choices based on this trade off (Goods/Services for $$). Now when you instead tax them, and the money is already gone, these same people will generally want everything that is covered for "free" even if it is not necessary, because to them there is no value in something that is free. They will also go to the Dr for the slightest thing, again, because its free, where if they had to pay for it, they may have waited it out since it was nothing serious. Its along the lines of why we charge for our time and services, because there is value in them.

That is what I am afraid will happen to our Health Care System. People will no longer see the value in it, and the system will become overwhelmed.

Quite a lot to take in, but there's my 2 cents for the day, lets see what tomorrow brings.

~Crazy

[For-Life]

$1000 a month he pays?

That is crazy. Exactly why the current health system is bad for businesses

[Crazy-bout-Optics]

$1000 a month he pays?

That is crazy. Exactly why the current health system is bad for businesses

Yes $1,000 may seem like a lot but I am guessing that this Dr (From what I read into it anyways) pays the whole amount instead of splitting it and passing $500 of the cost to the employee? (Do correct me if this is inaccurate). Also you do not know what is covered. That $1000 might actually be a Very good plan depending on what is covered and if here are any previous conditions. Either way, thats Capitalism for you.

~Crazy

[rdcoach5]

check out this web site http://www.pnhp.org/

[eyesonjohn]

[QUOTE=fjpod;321931]"One of the problems with our current health insurance system is, it is not mandatory for everyone to get it. Very often younger, healthier individuals will forego it for some other work benefit, or maybe it is not available at all in the workplace...but at the first sign of serious illness, everyone wants to sign-up. It's like getting into a car accident and trying to buy collision insurance after the fact. Everyone needs to pay in (even if it is some small amount for those in need), in order to have the benefit later when they may need it."



But buying collision insurance is not mandatory. If you want to compare how about the provision that bans declining coverage for pre-existing conditions. So if I don't have coverage now and go to the doctor and find out that I have cancer and will require extensive and very costly treatment I can leave his office go down the street to the local BCBS agent and buy a policy that will cover my treatment on day 1. If I don't have fire insurance on my house and it catches on fire can I call my insurance agent right after I call 911 and buy a policy? If insurance companies have to accept everyone without charging for the extra risk involved then the average price of coverage will have to increase dramatically.

[Chris Ryser]

From what I am aware of most forms of socialized medicine, and thats what is is, no matter how you cut it, does not pay for Glasses. If they do, such as in Medicare, what is paid out to the Dr and given as "free" to the Pt is minimal at best.

~Crazy

The 2 countries that paid fully for basic glasses............Germanu and the UK...............have dropped the system and will not pay for glasses anymore.

The only way to get glasses and dentist service paid is through a company run group insurance, with or without employee participation. These insurances cover just about everything that the healthcare system does not.

[fjpod]

Fortunately, or unfortunately (we'll see) the cost of eyeglasses is not what is driving HCR.

Too many people are uninsured, and hence not paying into the system, when they are young and healthy and disease free,...before they get pre-existing conditions. And then when they get sick, they expect the world to stop and pay for care to save their lives.

Maybe my comparison before to collision insurance was a little off. Shift it slightly to comprehensive (liability) coverage. Most states require you to have it before you can put your car on the road (which BTW was built with tax money from some people that use roads and some that don't).

[Crazy-bout-Optics]

The 2 countries that paid fully for basic glasses............Germanu and the UK...............have dropped the system and will not pay for glasses anymore.

The only way to get glasses and dentist service paid is through a company run group insurance, with or without employee participation. These insurances cover just about everything that the healthcare system does not.

Which is why I do not think the VSP's and the EyeMed's, nor the industry in general will be affected much by Gov run health plan. The only thing I could see would be in the Gov plan paid for, in full, a comprehensive eye exam from an Opthamologist.

[For-Life]

From what I am aware of most forms of socialized medicine, and thats what is is, no matter how you cut it, does not pay for Glasses. If they do, such as in Medicare, what is paid out to the Dr and given as "free" to the Pt is minimal at best. Being that we are a great Capitalist society, I don't think the average American would except in eyewear what the Government would like to give them.

Currently we have people with Medicare (Socialized Medicine) that also have a separate (private) vision plan. I don't think it will be any different under a Socialized plan here in the US, as I can't see the government paying for the Chanel, and Gucci frames that the patients will actually want and not the "BC" glasses that would be provided for "free" even though we all know that "free" in this case is not actually "free."

If anything I could potentially see a Socialized plan that favors OMD over OD, since they are after all "real" doctors, as the general public would probably perceive them to be anyway (Not my personal opinion).

While Capitalism is generally the least evil of all options, it is GREED that has gotten us to where we are today. When you switch from a private pay system to a "free" socialized plan what we will see is an abuse of the system.

What I mean by this is when people have to actually pay $$$ out of pocket for services and goods, they see value in it and make choices based on this trade off (Goods/Services for $$). Now when you instead tax them, and the money is already gone, these same people will generally want everything that is covered for "free" even if it is not necessary, because to them there is no value in something that is free. They will also go to the Dr for the slightest thing, again, because its free, where if they had to pay for it, they may have waited it out since it was nothing serious. Its along the lines of why we charge for our time and services, because there is value in them.

That is what I am afraid will happen to our Health Care System. People will no longer see the value in it, and the system will become overwhelmed.

Quite a lot to take in, but there's my 2 cents for the day, lets see what tomorrow brings.

~Crazy

I think you need to look outside the US and look at what other nations have. There is a lot of talk about this and that, and there is a lot of media stories about what happens in other nations (though, from what I have read, many of these stories are just flat out wrong and embellished).

I would believe that many of your concerns would be covered.

Yes, there are people that do go to the hospital for any old thing. But it is pretty small. I cannot think of anyone I know who has gone to the hospital or the doctor for something minor. And we have systems to deal with it. Nurse Practitioner Clinics is the newest one, where you can go and get checked out and they will tell you the next option. We do a pretty good job of keeping the costs in check.

But I see this as another benefit. The health care systems in most nations are outdated. In the past, when life expectancy was much shorter, health care was acute. You get sick, go to the doctor, and the doctor fixes it. Now, we are seeing more long term problems. Chronic pain, cancer, diabetes. Well then maybe having an older system is not the best. So as the government looks at the system, we have to find the best way to use what we have to developed a good path for health care. Hospitals are not for every problem. Maybe there is a better way of addressing it. So we set up these systems that are more cost effective and better for the patient.

[cocoisland58]

One of the problems with our current health insurance system is, it is not mandatory for everyone to get it.

How would you propose a way in which it is mandatory for everyone to buy into a health insurance policy? How can you enforce that? It will end up like auto insurance, people will initially buy into a plan and then drop it. What we need (IMO) is coverage for those who cannot afford coverage as it stands now, ie: the under-insured, the under-employed. There is already Medicaid for those who are indigent or near indigent and there are already paid plans that cover everyone else though I agree those paid plans either are expensive to maintain or don't cover enough. Even so, all a healthy individual ever needs is catastrophic coverage which is fairly cheap on average.

[fjpod]

...The only thing I could see would be in the Gov plan paid for, in full, a comprehensive eye exam from an Opthamologist.

Could you explain this statement? What is the relevance to HCR whether a comprehensive eye examination is done by an optometrist or opHthaLmologist?

[Crazy-bout-Optics]

Could you explain this statement? What is the relevance to HCR whether a comprehensive eye examination is done by an optometrist or ophthalmologist?

Absolutely. If the Gov does choose to include eye care in HCR they are going to look at both Optometry and Ophthalmology and look where the money they collect is best spent. The are also going to look at the HUGE Senior Citizen population, and those of the Baby Boomers and ask themselves how they, the Gov, can appease these folks. Is their money best spent on Optometrists whose main function is to provide an RX (while they can treat a *limited* number of diseases, it in no way comes as close to what an Ophthalmologist can treat), or is their money best spent on Ophthalmologists, medical doctors ,who are trained in surgery, can treat almost all eye diseases, and whose office can provide an Rx for glasses and contacts. Basically they can do everything an Optometrist can do and a whole lot more.

The original poster asked for an opinion and I did just that, gave my opinion. It doesn't mean it's right, it also doesn't mean it's wrong. The implication of the original post was that the topic is not discussed because it can get political. I think that it *could* get political if the Gov *chooses* to only allow Ophthalmologists to participate in their plan, or only "give" patients a free exam if they go to an Ophthalmologist since they could treat, help prevent, and diagnose a whole list of things that an OD could not, and would just end up referring the pt to an Ophthalmologist anyway. Why not beat them to the punch.

In some countries with Socialized medicine there are Ophthalmologists and Opticians, no Optometrists. So I think the only way eye care could get politicized is if it purposely excludes Optometrists or banned all private pay insurance programs (EyeMed VSP etc). And if it did, maybe then you, as an Optometrist, would see the relevance.

[FVCCHRIS]

Absolutely. If the Gov does choose to include eye care in HCR they are going to look at both Optometry and Ophthalmology and look where the money they collect is best spent. The are also going to look at the HUGE Senior Citizen population, and those of the Baby Boomers and ask themselves how they, the Gov, can appease these folks. Is their money best spent on Optometrists whose main function is to provide an RX (while they can treat a *limited* number of diseases, it in no way comes as close to what an Ophthalmologist can treat), or is their money best spent on Ophthalmologists, medical doctors ,who are trained in surgery, can treat almost all eye diseases, and whose office can provide an Rx for glasses and contacts. Basically they can do everything an Optometrist can do and a whole lot more.

The original poster asked for an opinion and I did just that, gave my opinion. It doesn't mean it's right, it also doesn't mean it's wrong. The implication of the original post was that the topic is not discussed because it can get political. I think that it *could* get political if the Gov *chooses* to only allow Ophthalmologists to participate in their plan, or only "give" patients a free exam if they go to an Ophthalmologist since they could treat, help prevent, and diagnose a whole list of things that an OD could not, and would just end up referring the pt to an Ophthalmologist anyway. Why not beat them to the punch.

In some countries with Socialized medicine there are Ophthalmologists and Opticians, no Optometrists. So I think the only way eye care could get politicized is if it purposely excludes Optometrists or banned all private pay insurance programs (EyeMed VSP etc). And if it did, maybe then you, as an Optometrist, would see the relevance.

Waiting for the counterproposal.....How about an O.D. give us one?

[fjpod]

Absolutely. If the Gov does choose to include eye care in HCR they are going to look at both Optometry and Ophthalmology and look where the money they collect is best spent. The are also going to look at the HUGE Senior Citizen population, and those of the Baby Boomers and ask themselves how they, the Gov, can appease these folks. Is their money best spent on Optometrists whose main function is to provide an RX (while they can treat a *limited* number of diseases, it in no way comes as close to what an Ophthalmologist can treat), or is their money best spent on Ophthalmologists, medical doctors ,who are trained in surgery, can treat almost all eye diseases, and whose office can provide an Rx for glasses and contacts. Basically they can do everything an Optometrist can do and a whole lot more.

The original poster asked for an opinion and I did just that, gave my opinion. It doesn't mean it's right, it also doesn't mean it's wrong. The implication of the original post was that the topic is not discussed because it can get political. I think that it *could* get political if the Gov *chooses* to only allow Ophthalmologists to participate in their plan, or only "give" patients a free exam if they go to an Ophthalmologist since they could treat, help prevent, and diagnose a whole list of things that an OD could not, and would just end up referring the pt to an Ophthalmologist anyway. Why not beat them to the punch.

In some countries with Socialized medicine there are Ophthalmologists and Opticians, no Optometrists. So I think the only way eye care could get politicized is if it purposely excludes Optometrists or banned all private pay insurance programs (EyeMed VSP etc). And if it did, maybe then you, as an Optometrist, would see the relevance.

OK, you are entitled to your opinion. So am I.

My opinion is that the government should eliminate the profession of opticianry becasue they do nothing but drive up the cost of eyewear, and optometrists and ophthalmologists could easily handle their job. In fact anybody with about an hour of training could handle the job of an optician. This would save untold millions of public dollars. They are only limited to taking a few facial measurements. They can't even tell which eye is right and which is left if it weren't for the prescription which was written for them by an optometrist or ophthalmologist.

Yes you are entitled to an opinion, my friend, but you are misguided,... just as the above paragraph is tongue-in-cheek...but at least now you know how to spell ophthalmologist.

[fjpod]

Health Care Reform is not a time for professions to exhibit devisiveness. Or for special interests to put their cause ahead of anothers.

There is plenty of work for all.

Crazy feels that ODs are very limited in their scope and therefore should be left out. If optometrists are limited in scope, what are opticians?

Sensible health care would utilize the best trained personnel for the job. This would be efficient use of resources.

There is no way ophthalmology could handle primary eyecare alone.

I will not go into what an OD is legally allowed to do or not do...frankly if folks in the ophthalmic community don't know, then there is no sense...

[Johns]

OK, you are entitled to your opinion. So am I.

My opinion is that the government should eliminate the profession of opticianry becasue they do nothing but drive up the cost of eyewear, and optometrists and ophthalmologists could easily handle their job. In fact anybody with about an hour of training could handle the job of an optician. This would save untold millions of public dollars. They are only limited to taking a few facial measurements. They can't even tell which eye is right and which is left if it weren't for the prescription which was written for them by an optometrist or ophthalmologist.

Yes you are entitled to an opinion, my friend, but you are misguided,... just as the above paragraph is tongue-in-cheek...but at least now you know how to spell ;) ophthalmologist.

10-18-2009, 04:37 PM
fjpod
Master OptiBoarder
Occupation: Optometrist



Join Date: Oct 2005
Location: new york
Posts: 1,196


"Like I said...there is something about the internet that makes people behave differently.

Again, no specific disrespect was intended towards one member of Optiboard. Simply making a statement about common courtesy and respect for others."

[fjpod]

10-18-2009, 04:37 PM
fjpod
Master OptiBoarder
Occupation: Optometrist



Join Date: Oct 2005
Location: new york
Posts: 1,196


"Like I said...there is something about the internet that makes people behave differently.

Again, no specific disrespect was intended towards one member of Optiboard. Simply making a statement about common courtesy and respect for others."

I guess you didn't read the part where I said it was "tongue-in cheek".

Perhaps you could explain why optometry could be/ or should be excluded in HCR?

Perhaps you can explain how an eyecare professional such as Crazy exhibits common courtesy and respect for others when he/she makes lame statements about another ophthalmic profession.

Isn't this board partly for the purpose of the three O's getting together and learning from each other, while at the same time showing a little mutual respect?

I'm beginning to think you don't like me, Johns. And I knew if somebody looked hard enough they would find a typo in my post. Mispelling ophthalmologist (twice) on an optical forum is not a typo.

[Johns]

Isn't this board partly for the purpose of the three O's getting together and learning from each other, while at the same time showing a little mutual respect?

I'm beginning to think you don't like me, Johns. And I knew if somebody looked hard enough they would find a typo in my post. Mispelling ophthalmologist (twice) on an optical forum is not a typo.

Actually, all I posted was:

The rest were all your words, not mine.

But honestly now...rubbing a nose in someone's misspelling isn't the highest form of respect.:shiner: Is it?

And as far as me liking you: I LOVE YOU MAN!! (I'll quit there, before I get accused by Geta-Life of hijacking another thread).

And let's keep up the Love, Respect, and Admiration for each other. After all, we're all going down together! (Some of us just faster than others.)
:cheers:

[scriptfiller]

With respect to the current bills passed in the House and under consideration in the Senate, does the government have a right to make one of its citizens purchase something.

It is my understanding that there are monetary penalties involved for individuals who do not purchase and for companies who do not offer health insurance.

How many people who are legal United States citizens are really "un-insured"?

How many healthy people do not have insurance because they see it as an un-needed expense? Are these people considered un-insured?

Am I considered un-insured or under-insured owing to the fact that I only have a "hospital only" insurance plan.

Let health insurance be provided across state lines, this will create competition on a national basis and will drive down costs.

Lets get the lawyers out of the exam rooms and surgery center, remember this is the practice of medicine. Sure there are cases of blatant malpractice but it seem when the littlest thing that goes wrong, let's sue.

Always remember, no one has a right to another's time and property.

[YrahG]

I see the point crazy was trying to make. An optometrists professions consists of taks that are a subset of an ophthalmologits. Their is nothing specific that an optometrist can do that an ophthalmologist can't do. Opticians I don't see as ever going away completely, simply because history has shown that we are willign and able to be stepped on so wages can be lowered with very little consequences or backlash from opticians as a profession, in essence we work like dogs and have no teeth so there is no fear of a bite.

I think ophthalmic technicians stand in a great positions since they refract, and perform many of the diagnostic tasks that are necessary in routine eyecare at lower wages and an adequate educational level. At the turn of the last century the ophthalmic professions had a radical change, the oculist (not to be confused with the ocularist) went extinct, the optician split into two refracting (now the optometrist) and the dispensing. This optometrists replaced the need for an oculist, the oculist was a medical doctor without surgical residency or an ophthalmologist that could not perfrom surgery. The need didn't exists and the proffesion of optometry offered refractions which were a need for many consumers at the time.

I think that HCR is a good idea, but I don't think anyone or any profession get's a pass we can all perform tasks more efficiently, we can all cut costs somewhere. I just hope those costs and efficient tasks don't degrade our profession.

[Refractingoptician.com]

Ours is a pretty good system here in Canada . We are all covered and if there is something special we need then we can quite often do the out of country thing and bill it to our OHIP insurance . This gives us decent care here and access to the best of your system as well .

We are not one sickness away from bankruptcy either . And no one is afraid to go the hospital to have something checked out .

Not perfect of course , but pretty darn good !