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Is your doctor paid to keep you healthy? Probably not.
St. Louis Post-Dispatch ^ | 06/17/2006 | Mary Jo Feldstein

Posted on 06/20/2006 6:45:05 AM PDT by newgeezer

Georgia Lewis' feet were so swollen with fluid that she wore sandals throughout the winter. Lewis, a diabetic who lives in Bellefontaine Neighbors, was giving herself five insulin shots a day but still couldn't regulate her blood sugar.

Years after being diagnosed with diabetes, Lewis, 61, had never learned how to manage her disease or shield herself from its most debilitating effects.

Under the traditional Medicare system, it wasn't in her doctors' financial interest to teach her.

But now, as part of a expanding Medicare program that could transform how the nation cares for its elderly, Lewis' doctors will be responsible for the cost if her health problems turn into expensive complications.

Typically, physicians get paid only when their patients receive care, and more complex care often brings bigger paychecks. At the same time, doctors complain that paltry payments for office visits force them to rush through checkups instead of educating patients about their illnesses, medications and healthy living - all of which might lower future medical bills.

It's a system that gives doctors little financial incentive to keep patients well. And, experts say, it might be contributing to dangerous, unnecessary care as well as high medical bills.

...

Medicare, the government program that provides health care to 42 million older Americans, is experimenting with paying private insurers a per person rate. It's similar to how health maintenance organizations, or HMOs, work. Under this program, called Medicare Advantage, the fee is used to cover the patient's medical expenses, and the insurer keeps the rest. The hope is that the plans will encourage better management of illness to avoid expensive flare-ups.

...

In Lewis' case, the private insurer...was created by a group of St. Louis-area physicians. In theory, the healthier Lewis stays, the bigger the profits for her doctor. ...

(Excerpt) Read more at stltoday.com ...


TOPICS: Constitution/Conservatism; Culture/Society; Extended News
KEYWORDS: healthcare; medicaid; medicare
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To: newgeezer

My Dr was quite blunt with me back in Jan. when after three ER trips thinking i was dying i was told i have diabetes, She looked me in the eye and said change your whole lifestyle or you will die. she gave me a diet plan to follow sent me off to a dietian and then said I was the only one who could make myself better through diet and excerise. its 6 months and i have lost 52 pds ride my bike and walk every day and have a new lease on life! im off the blood pressure pills and the diabetes is in remission. And i have read everything i can about diabetes i wasnt in the dark i found out what i needed to do from the Dr and by using my head. some people just dont want to find out its called denial.


21 posted on 06/20/2006 7:32:03 AM PDT by suzyq5558 (I cant find my old tag)
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To: thoughtomator

Thanks. Probably a wise choice.


22 posted on 06/20/2006 7:32:37 AM PDT by newgeezer
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To: newgeezer
(sarcasm)Since socliaizing the medical care industry caused so much of this... let's socialize it some more! That'll work... Right???(/sarcasm)

People never learn...

23 posted on 06/20/2006 7:33:29 AM PDT by Dead Corpse (It is not the oath that makes us believe the man, but the man the oath.- Aeschylus)
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To: NorCalRepub
Whether they care or not, Doctors are not trained in "health", they are trained in disease....most don't know more then superficial nutrition and I've never met one who exercises much......

You should meet my doctor. Prevention is his primary focus, and he spends a good amount of time with his patients. I've never been rushed out of his office so he could dash off and see someone else.

24 posted on 06/20/2006 7:35:26 AM PDT by Not A Snowbird (Official RKBA Landscaper and Arborist, Duchess of Green Leafy Things)
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To: newgeezer; Vectorian

Significant co-pays, deductibles and limits in Medicare, which also covers the disabled.


25 posted on 06/20/2006 7:36:46 AM PDT by From many - one.
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To: NorCalRepub

You never met me then.


26 posted on 06/20/2006 7:38:19 AM PDT by tomswiftjr (Remember Pearl Harbor)
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To: suzyq5558
Congratulations!

Similarly, a very obese friend was diagnosed with early (or pre-?)diabetes. His doctor told him the obvious cause was his weight, and he could help himself greatly by shedding the excess pounds. He committed to exercising and went on a low-carb diet; he lost nearly 100 pounds.

That was a couple years ago. His diabetes, like yours, is in remission. He continues to exercise and eat smart.

Best wishes to you and keep up the good work.

27 posted on 06/20/2006 7:43:42 AM PDT by newgeezer
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To: Vectorian
Who pays for Medicare and who is elligible to receive it? What types of care are covered and which aren't?
________________________________________________________________
Taxpayers pay for it.
Disabled, retired, medically unable to work, receive it.
Covers 80% of the $.
You pick the Dr.
Everything is covered, but everything has politically determined limits.
Elective procedures go to a review board.
Private insurance & Union coverage is available to cover the co-pays.

Then there's medicAID. 100%

Doctors are not required to accept any of it, as everything has a predetermined price schedule. Not every Doctor can accept any of it.

Dental, drug disbursing, home medical care, equipment and transportation is determined by varying levels of need.

Second only to the bazillion word Tax code, Medicare is a word-smiths bonanza.
28 posted on 06/20/2006 7:54:01 AM PDT by JoeSixPack1
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To: newgeezer
I'm buying stock in this company.
29 posted on 06/20/2006 8:18:47 AM PDT by pabianice
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To: twigs
It's just hard for me to imagine this. My husband was diagnosed with diabetes in January. We've been swarmed with info from lots of different sources. First of all, his doctor's office has several nurse practictioners who instruct patients with certain illnesses, diabetes being one of them. We weren't convinced by all she told us, so we went looking on our own. After my husband received his first diabetic medication, we received info from the drug company, with lots of additional resources. Then we've been reading up on our own. Yes, we did take our own initiative, but we also received help from "the system." Lots of it.

Almost ditto here regarding my wife. She's pre-diabetic, and is now dieting, exercising and taking Metformin and checking her blood twice a day. She's lost about 15 pounds in 6 weeks, and her sugar is coming down. The doc's office had LOTS of info - there's no excuse these days for not having information about a disease - every library has a computer with Internet access, so its available.

30 posted on 06/20/2006 8:22:17 AM PDT by Ancesthntr
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To: newgeezer

Mine is. She really gets on my case if I'm not taking care of myself. But, hey, why not indict an entire indusry rather than just take personal responsibility for our choices in doctors?


31 posted on 06/20/2006 8:25:23 AM PDT by Larry Lucido
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To: newgeezer

BUMP FOR LATER


32 posted on 06/20/2006 8:27:10 AM PDT by jamaly (I will never forget 9-11-01!!!!)
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To: Lokibob

That's out there, but not in my office. In my case it's often the client who demands money-wasting, antagonistic, contentious motion after motion. I try to focus them on what is the most acceptable outcome and get there by the most economical means possible. Many clients dump me (if I don't withdraw first) for not being "aggressive" enough, but I refuse to waste their money and my time.


33 posted on 06/20/2006 8:29:41 AM PDT by Larry Lucido
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To: JoeSixPack1
"Who pays for Medicare and who is elligible to receive it? What types of care are covered and which aren't?
________________________________________________________________
Taxpayers pay for it.
Disabled, retired, medically unable to work, receive it.
Covers 80% of the $.
You pick the Dr.
Everything is covered, but everything has politically determined limits.
Elective procedures go to a review board.
Private insurance & Union coverage is available to cover the co-pays."

Thats partially true, the people on Medicare also pay for the coverage and they must pay again for the drug coverage, with wildly different rates depending on the state you live in.
Private insurance is available, but any pre-exisisting conditions will be excluded, again, depending on the state you live in.
34 posted on 06/20/2006 8:30:30 AM PDT by Beagle8U (Liberals get up every morning and eat a big box of STUPID for breakfast)
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To: Beagle8U

I was just trying to cover the basics. :-)


35 posted on 06/20/2006 8:38:33 AM PDT by JoeSixPack1
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To: newgeezer
The following is from the rather lengthy article--

A study released last month by the Dartmouth Atlas Project found dramatic variations in how doctors and hospitals nationwide care for elderly, chronically ill patients. Patients who received more care didn't necessarily receive better care. But if all patients received the highest-quality, lowest-cost care, Medicare could have saved $40 billion, or one-third of the total spent.

Regarding the woman in the story, from the last few paragraphs--

Lewis has lost 20 pounds since she started attending the diabetes discussion group. She's also gained control of her blood sugar and cut back her insulin to two shots a day. On a recent Thursday, she had her greatest victory. When she was getting dressed for the discussion group, Lewis tried on her new gym shoes, and they fit.

It was the first time she had been able to wear shoes with ties in months. Now, she's ready to begin exercising.

It appears she is getting some effective diabetic education however, much permanent damage has already been done to many of her body systems.

36 posted on 06/20/2006 8:39:03 AM PDT by Tarheel (Good fences make good neighbors--R. Frost)
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To: NorCalRepub
Dr. Mark Hyman and Functional Medicine seems to have found the answer to poor health. It's all about food food food...he changes folks from eating junk, processed foods into eating REAL FOOD...and brings folks back into great health. What a blessing to see a few docs moving into this new medical field called functional medicine. Below is a link to his web site...I'm not pushing him in particular, I'm directing folks to investigate functional medicine.

Did the food industry, big pharma and conventional medicine, FDA design poor health throughout America for the mighty buck? Dr. Hyman says so.

http://www.drhyman.com/

37 posted on 06/20/2006 8:39:23 AM PDT by shield (A wise man's heart is at his RIGHT hand; but a fool's heart at his LEFT. Ecc. 10:2)
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To: Ancesthntr

Good for your wife! I hope that she avoids the disease.


38 posted on 06/20/2006 8:39:43 AM PDT by twigs
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To: pabianice
I'm buying stock in this company.

Right away in their description there is a false statement about 'positive and negative ions' ... ions are only negative. There is no such thing as a positive ion.

It would be great if this works but how will you know? Do they do an analysis of your urine before and after to show you toxin removal? That wasn't clear to me.

39 posted on 06/20/2006 8:40:37 AM PDT by GOPBiker (What goes down your neck counts. There is no free lunch.)
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To: newgeezer
Years after being diagnosed with diabetes, Lewis, 61, had never learned how to manage her disease or shield herself from its most debilitating effects.

Your health is your responsibility. Always ask questions. Get aggressive if need be. You are the doctor's boss.

This attitude is why I have learned to manage the health problems I've had. I don't pout about "not understanding." I ask questions until I understand.
40 posted on 06/20/2006 8:41:53 AM PDT by Xenalyte (The wages of sin are death, but after taxes are taken out it's just sort of a tired feeling.)
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