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Medicaid Plan Prods Patients Toward Health
The New York Times ^ | 12/1/06 | Erik Eckholm

Posted on 12/01/2006 8:40:32 PM PST by Eric Blair 2084

HAMLIN, W.Va. — No question, John Johnson is a doctor’s nightmare. “I guess I’ll have to sign it,” she said of the pilot agreement. Speaking from the easy chair where he spends his days in a small wooden house near this small Appalachian town, his left trouser leg folded by a safety pin where a limb was lost to diabetes, he lighted another cigarette. Mr. Johnson, 61 and a former garbage collector, takes insulin and goes to a clinic once a month for diabetes checkups. Taxpayers foot the bill through Medicaid, the federal-state health coverage program for the poor. But when doctors urged him to mind his diet, “I told them I eat what I want to eat and the hell with them.” “I’ve been smoking for 50 years — why should I stop now?” he added for good measure. “This is supposed to be a free world.” Ignoring doctors’ orders may now start exacting a new price among West Virginia’s Medicaid recipients. Under a reorganized schedule of aid, the state, hoping for savings over time, plans to reward “responsible” patients with significant extra benefits or — as critics describe it — punish those who do not join weight-loss or antismoking programs, or who miss too many appointments, by denying important services. The incentive effort, the first of its kind, received quick approval last summer from the Bush administration, which is encouraging states to experiment with “personal responsibility” as a chief principle of their Medicaid programs. Idaho and Kentucky are also planning reward programs, though more modest ones, for healthful behavior.

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


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: biggoverment; medical; nannystate
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To: berdie

Spirited debating and lots of good things learned here... I can't say the same for a lot of other political websites!


21 posted on 12/01/2006 11:13:46 PM PST by cyborg (No I don't miss the single life at all.)
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To: cyborg
Sixty isn't even old but he sounds set in his ways and is typical of the mentality of poor people who have food as their chief enjoyment in life. I suppose a lifetime of diabetes drugs is his future. I work with diabetes patients who have open sores and the whole bit. I can't imagine why someone would WANT that for themselves.

I can go along with set in his ways but the "typical of the mentality of poor people who have food as their chief enjoyment in life" I disagree with. I know many fat people who are not poor and don't believe it is a 'mentality' specific to the poor. I suppose if I had no leg I would eat too because he probably sits a great deal of the time. What is that saying about walking in someone else's shoes.

It has always been my understanding that the diabetic who has the type that sores develop, don't heal and become larger turning to gangrene causing loss of limbs is a type that is not food driven but some failure of the body. Aren't these the folks that require shots multiple times a day? I am not sure but I did know a person who was not fat and did not smoke and lost one leg at a time until death and early death was not unexpected.

You know I am a patient just like him. When I was young I couldn't wait to get on my own so I could make all my decisions. How wrong I was, I got married and I had a husband to take part in my decisions.

Then, I had kids and decisions were based on others needs. Then I went to work and decisions were dictated by a boss.

The incident that affected my determination took place many years ago. I went to a dentist who was a health-nut and bent my ear on the value of giving up sugar to the point that I quit going to him.

When I went through menopause my current Dr told me he wanted me to go on HRT. It was the be all solve all at that point in time. (Not to mention the money the drug companies made off it). I told him I would do so just as soon as he prescribed something to stop the hair growing out my husband's nose and ears. We laughed and of course I never did it. As you know, it was much later determined that HRT treatment was not what it was cracked up to be.

I believe it is the patient who has the right to make the decision regarding the path their medical treatment will take. It is the Dr's obligation to present options but they are options. If they are so correct in their vast knowledge we would not have to sign consent forms at the hospitals.

When I retired I said now, I DO, WHAT I WANT-WHEN I WANT-AND IF I WANT and I will no longer let someone else tell me what I have to do. I did my time, pay my bills and no one buys my beer so to speak. I have found the older I get the more determined I am to do things MY way and I have become much more set in my ways. And you know what, I can't even die without someone telling my husband what he has to do with me. It is about money, money, money. I would just as soon be stretched out on the couch for my family and a hole dug in my back yard to bury me. Can't do that--there would be no way to line the many many many pockets along the way. So yes, I will make my own decisions and thankfully my Dr. doesn't mind.

I so wish we would quit judging everyone on stupid habits. We all have bad habits or live on the edge or make stupid mistakes of one kind or another and as to the system, what is good today is bad tomorrow and vice versa. They can't make up their mind but they want us to jump to their tune. When I was young they wanted to control population to two kids per family--now they want more kids at the same time we are opening our borders wider. Must be controlling population went out of fashion. As I said earlier, WE ALL FEED AT THE GOVERNMENT TROUTH IN ONE WAY OR ANOTHER. It could be a simple tax break.

22 posted on 12/02/2006 12:12:41 AM PST by Snoopers-868th
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To: Extremely Extreme Extremist

I second that motion!!


23 posted on 12/02/2006 4:18:27 AM PST by stopem (God Bless the U.S.A the Troops who protect her, and their Commander In Chief !)
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To: cyborg

Here's a thought there are some Physicians who do NOT accept medicaid, maybe if more Doctors stopped accepting it than there would be no more medicaid for the illegals and all the moocher freeloaders!!


24 posted on 12/02/2006 4:21:25 AM PST by stopem (God Bless the U.S.A the Troops who protect her, and their Commander In Chief !)
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To: Snoopers-868th

Comparing doctors to plumbers is apples and oranges.


25 posted on 12/02/2006 6:39:11 AM PST by Extremely Extreme Extremist (Why can't Republicans stand up to Democrats like they do to terrorists?)
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To: Extremely Extreme Extremist

Whatever! They both offer a service and nothing more. The leave their job at 5:00 and although they may be on call so is the plumber in case of emergency.


26 posted on 12/02/2006 2:11:28 PM PST by Snoopers-868th
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To: Snoopers-868th; cyborg; berdie; Extremely Extreme Extremist; sockmonkey; Panzerfaust; stopem; ...

Thanks to everyone for a heated and important discussion. This cuts right to the rationale behind smoking bans and other health initiatives. At least we can discuss it honestly knowing what the real motivation is; DEMAND SIDE HEALTH CARE REDUCTION.

How do we socially engineer a world where people don't eat, drink, smoke or engage in unsafe sex so much? We can't cut the socialist health entitlement programs, so let's reach for straws.

The ETS argument is a farce and doesn't even pass the laugh test. As outlined in the 1993 ASSIST study, the real goal is to coerce people into not smoking by making it inconvenient and socially unacceptable.

I'll link to the study. The goal was to reduce smoking rates to below 10% in 15 years. How to accomplish this besides high taxes? "Protect non smokers from exposure to Second Hand Smoke".

Think about this for a second...What do SHS and non smokers have to do with reducing smoking rates???????? Red flag. Read between the lines.

The liberal progressives will follow the same successful blueprint with fast food.

_________________________________________________

Gabz, SheLion; need your help again. Please ping this. Thanks. I promise it will be the last time I ask.


27 posted on 12/02/2006 3:06:24 PM PST by Eric Blair 2084 ("I love the smell of tobacco smoke in a bar, it reminds me of freedom.")
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To: Eric Blair 2084
DEMAND SIDE HEALTH CARE REDUCTION.

Now you have hit the nail on the head. Think of all the areas that could fit into that category should any National Plan be implemented (which I think we can count on in the near future). Euthanasia in the making of a different type if people are subjected to lifestyle confrontations at their doctors office and then subsequently rejected when programs are not adhered to. (By the way, who will be implementing the programs that would qualify--another government funded program)?

I know many folks on this website do not believe in employee pensions and health plans but I can say that when I went to work many years ago I sought a job that provided those two specific plans. A good job was with a organization that offered both and you had to have some qualifications or be some type of benefit to the organizations who offered the benefits. It warps the minds of people who have dedicated their life to an organization to have that same organization and the politics of the nation turn their back on them and call them freeloaders when they enter the sunset years of their lives. These people were not freeloaders. They were living life in the same manner as the working young people are today. Doing what they had to do to get by.

So you have posed a really good question followed by an excellent statement that catches many people (who may or may not be liberal progressives) on the edge quite unexpectedly. They are at the mercy of corporations and their desire today to not honor the contract (if you will) when the time arrives. There is no way for them to recover via any stock market at such a late date.

I have to agree that you have spotted the very plan regarding "Demand side health care reduction". I believe it is going to be forced on all of us and it will severely affect the above folks that have no way to change the last 50 years of their lives. I do not however, believe it is solely a Liberal game of bait and switch.

I have no idea what the answer is but I do know that my medical insurance as opposed to health care has changed dramatically from when I first went to work. It has evolved into covering everything from a hangnail to a serious disease. Is it the right thing to do to throw me to the government because Hillary decided ALL deserved to have health coverage. The most dramatic insurance changes came after the Hillary Plan. This is when insurance companies (business) jumped on the wagon and started to tell Dr's what they would and would not pay for.

On the other hand, and regarding no National Plan, should we as caring people throw the less fortunate to the wolves. There used to clearly be two plans; one operated by the company you worked for and the other by the government. The latter two plans have and are falling apart because of the political benefit to both parties to combine and create an even bigger program. The bigger program may by some be perceived to be a liberal program but it benefits business equally well. Business no longer feels obligated to provide such benefits.

It boggles my mind and is just another reason to make me wonder where I really stand politically. I keep searching for the government that is for the people--not against them.

Your "DEMAND SIDE HEALTH CARE REDUCTION" PLAN has pointed out something even more scary than I had previously thought but it certainly reinforces my opinion a new type of Euthanasia is on the horizon.

28 posted on 12/02/2006 5:52:52 PM PST by Snoopers-868th
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To: Snoopers-868th

Snoop, I'm glad you get it. You made my day. I was beginning to think that I was the only sane person in an insane world. In which case I would be insane.

___________________________________________________________
you wrote:

I know many folks on this website do not believe in employee pensions and health plans but I can say that when I went to work many years ago I sought a job that provided those two specific plans.
___________________________________________________________

I hear you. My mother worked for the State of NJ for 35 years. She drove around in a K-car with no radio, no A/C or heat for 3 f#@&ing decades. She made little money and was passed over for promotions every year. All for me and her family. She hated every second.

She was promised a fat pension and generous health benefits when she retired. That's what kept her going. She earned it.

Thankfully, now her and and my Dad are perpetually in one of three states...either on vacation, just got back from vacation, or about to leave for vacation.

This is going to be a tough one for me if I am fortunate enough to win a NJ state assembly seat.

The public pension system is really way too rich. The state will be bankrupt if no changes are made.

I dunno. I have mixed emotions. Sort of like Osama bin Laden driving off a cliff...in my brand new Mercedes E320.



29 posted on 12/02/2006 7:18:08 PM PST by Eric Blair 2084 ("I love the smell of tobacco smoke in a bar, it reminds me of freedom.")
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To: Snoopers-868th; Eric Blair 2084

Hillary Care would have decimated health care as we know it. Pray that she never gets elected to a position where she could bring it up again.


30 posted on 12/02/2006 9:15:36 PM PST by cyborg (No I don't miss the single life at all.)
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To: Eric Blair 2084; Just another Joe; Madame Dufarge; Cantiloper; metesky; Judith Anne; lockjaw02; ...
Gabz, SheLion; need your help again. Please ping this. Thanks. I promise it will be the last time I ask.

No problem at all.  Sorry I am late with this.  I wasn't around much yesterday.

31 posted on 12/03/2006 2:47:59 AM PST by SheLion (When you're right, take up the fight!!!!!)
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To: SheLion; Eric Blair 2084; cyborg; Snoopers-868th; Extremely Extreme Extremist; berdie
Seems as good a time as any to repost this:

In Praise of Bad Habits

32 posted on 12/03/2006 4:16:02 AM PST by metesky ("Brethren, leave us go amongst them." Rev. Capt. Samuel Johnston Clayton - Ward Bond- The Searchers)
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To: metesky
Seems as good a time as any to repost this:

In Praise of Bad Habits

Thanks metesky!  I didn't book mark it the last time you posted this, so I was sure to save it this morning!


33 posted on 12/03/2006 4:35:27 AM PST by SheLion (When you're right, take up the fight!!!!!)
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To: Eric Blair 2084

From the article:
Those signing and abiding by the agreement (or their children, who account for a majority of Medicaid patients here) will receive “enhanced benefits” including mental health counseling, long-term diabetes management and cardiac rehabilitation, and prescription drugs and home health visits as needed, as well as antismoking and antiobesity classes. Those who do not sign will get federally required basic services but be limited to four prescriptions a month, for example, and will not receive the other enhanced benefits.



Limiting prescriptions to four a month?
And none of the above treatments - if not signed?

Are doctors now bureaucrats?

Instead of the hippocrates oath....
Will they now take the Bureaucratics Oath?

MD's turned into BD's


34 posted on 12/03/2006 9:24:08 AM PST by libertarian27
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To: SheLion

Thanks for the ping!


35 posted on 12/03/2006 9:59:31 AM PST by Alamo-Girl
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To: metesky

Long but great read!


36 posted on 12/03/2006 10:00:34 AM PST by gidget7 (Political Correctness is Marxism with a nose job)
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To: metesky

Thanks for the article. Long EXCELLENT, eyes-wide-open, read. I will be giving this article to my Dr?

I suggest the young people who buy into this nonsense have far more to worry about than the taxes they believe will be stolen from them to pay SS or this plan.


37 posted on 12/03/2006 10:48:12 AM PST by Snoopers-868th
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To: SheLion; Eric Blair 2084

I'm getting a little tired of being "prodded", so I started "prodding" back at 'em.


38 posted on 12/03/2006 6:07:10 PM PST by elkfersupper
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To: Mears

bump


39 posted on 12/03/2006 7:28:53 PM PST by Mears
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To: Mears

Some of the things that get to me about the nanny statists is these:

There are people, who by virtue of nothing except excellent genetics, are just about impervious to the ill effects of bad diet, bad hygiene, smoking, even drug abuse...there are people who can take any amount of heroine and just never become addicted...

There are people who are very pleasant to be around when they choose their own lifestyle, yet when others use social pressure and medical disapproval to force them to change against their inclination, become as bad or worse than the worst health nazi, and unhappy to boot.

There are people who live very healthy lifestyles and give themselves every physical advantage who die young of various cancers, heart diseases, accidents, diabetes, kidney disease, birth defects, environmental toxins, infections, etc. Living a healthy lifestyle will not protect anyone against the unforeseeable.

I just cannot understand telling anyone how to live, or what choices they must make. I can understand telling people that there are likely consequences (good/bad) to certain lifestyle choices (healthy/unhealthy), but that they are not inevitable. That's truth.

And I certainly cannot understand coercion, either societal, medical, familial, emotional, legal, financial or otherwise.

These people who are criticized for their smoking or eating habits--are chastised (in many cases, not all) by the very same people who encourage alternative sexual lifestyles, abortion, unwed motherhood, unrestricted immigration and citizenship, etc.

Just my opinion, ymmv.


40 posted on 12/03/2006 10:10:36 PM PST by Judith Anne (Thank you St. Jude for favors granted.)
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