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Old 08-22-2013, 10:37 AM   #21
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No one can predict the future, but I suspect routine/scheduled medical care will indeed become more of an international commodity in the coming years (decades?). As a part of that process, US health care costs will eventually moderate down towards ave of the developed world. All players in US health care (inc. docs, nurses, hospitals, drug/equipment makers, etc) will gradually get paid less under a system of tighter gov't control. What this means to care quality & access in US remains to be seen. But it's worth remembering that many foreign docs trained in the US, there are some great teaching centers throughout the world, and many of the top advances in care were/are being developed in a number of countries across the globe. And as has been noted before, the very high $$$ of US care nets very little (if anything) in terms of statistically measurable better outcomes vs many other developed nations with lower ave costs.
+1. Seems inevitable...though I assume it will take a long, long time. The only people who seem to argue for the US status quo (no one in this thread), seem to leave the realities of US outcomes and the economics out when making their "case."
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Old 08-22-2013, 11:28 AM   #22
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From USA Today this morning, it seems the data does not support the oft-mentioned bullet point that doctors are not taking Medicare patients. Report: More doctors accepting Medicare patients
Interesting that this data is from US gov't, not an independent source. USA Today has previously reported a big disparity between Gov't statements and other sources regarding this issue.
Doctors limit new Medicare patients - USATODAY.com
Most independent data seem to indicate there is indeed a trend towards fewer docs accepting Medicare, at least in some regions.

Primary Care Physicians Are Leaving Medicare
In Florida, Obamacare to Cause 27% of Doctors to Stop Accepting Medicare Patients - Forbes
http://www.nytimes.com/2009/04/02/bu...alth.html?_r=0
More Doctors Steer Clear of Medicare - WSJ.com
Drop in Physician Acceptance of Medicaid, Medicare Patients

And a large (13,000+ responses) independent physician practice survey in 2012 found that about half of docs now restrict access to Medicare patients (i.e. see only limited #'s, refuse new MC pts, etc.).
http://www.physiciansfoundation.org/...ial_Survey.pdf
Recent experiences of close older relatives in major Midwest metro area are consistent with this survey- at least for difficulty in finding specialty care.

Physician access under MC may not be a crisis, but many (inc me) find it inaccurate & short-sighted for Gov't to claim it's a non-issue.
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Old 08-22-2013, 11:51 AM   #23
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Just goes to show that we can find some type of data to support just about any view. When it comes to physicians and Medicare, there has always been talk about how doctors are under-reimbursed and committed to reducing their Medicare practice levels. That may be the case in some areas, but overall the trend is clearly going in the opposite direction. Their surveys all proclaim their intention to focus their practice private insurance but hard billing data shows them doing the opposite. This is not a surprise, as one of their objectives would be to influence medicare rate setting. Also, because they are free to have multiple employers and practices, some can be open to Medicare while others are not, enabling them to fish in both ponds.
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Old 08-22-2013, 12:10 PM   #24
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Thanks guys. I really appreciate your good wishes.

I guess I may have put it off longer than I really had to. I would read about how bad people felt, how they could hardly walk, and think well that is not me. But I haven't been dancing in almost a year now. And before long I may be too ugly to find partners, so best get going. I still have a while to wait, as he has a backlog to work off.

My surgeon showed me the x-ray. Really no joint left. He said that is not uncommon- some people just don't seem to recognize pain the way most people do. I used to have a tee-shirt "Pain is just weakness escaping the body". I thought is was a joke.

Ha
That will never happen.

...but I do want you to feel better.
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Old 08-22-2013, 01:37 PM   #25
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That will never happen.

...but I do want you to feel better.
"Too ugly to find partners"... Bbbam, you are correct that will never happen. Ha, is one of the smartest people on the forum. He should know its a numbers game. Just by staying alive he has outlived the competition and his odds of finding females increases as he gets older!
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Old 08-22-2013, 01:48 PM   #26
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"Too ugly to find partners"... Bbbam, you are correct that will never happen. Ha, is one of the smartest people on the forum. He should know its a numbers game. Just by staying alive he has outlived the competition and his odds of finding females increases as he gets older!

In the over 65 meat market, many women exclaim: but my man can walk!

Seriously, hope it all goes well HA.

Good luck and many dances.
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Old 08-22-2013, 03:47 PM   #27
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Another major factor changing the US business of medicine has been the increasing trend of docs (inc specialists) to become salaried employees of health care organizations. In fact the % of doc-owned practices in US dropped below 50% back in 2008.
http://www.nytimes.com/2010/03/26/he...gewanted=print

So increasingly the ultimate decision to accept or not accept new patients (MC, foreign, or whatever) is resting not with the individual doc but with an administrator

Ha- Seems like you made the right call to have the hip replaced now.
Best of luck for speedy recovery.
--And make sure that hospital has WiFi so you can get right back to posting here during your stay!
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Old 09-04-2013, 09:57 AM   #28
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Not to make light of the above but the UK seems to have an new enlightened outlook on medical and health studies:

Government policy to be anecdote-based
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Old 09-04-2013, 10:22 AM   #29
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Not to make light of the above but the UK seems to have an new enlightened outlook on medical and health studies:

Government policy to be anecdote-based
You know that site is satire, right?
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Old 09-04-2013, 10:37 AM   #30
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I did not see this thread until just now. (Why?)

ha, sorry to hear of your condition, but I am not worried about you. You know already, but from several sources I understand that Seattle is one of the best places in the world for joint replacement and the like. My brother and his wife have had various joints replaced there with state-of-the-art technology and excellent results. Bro is a big lug in a very physical job, by the way.

Best of luck.

Ed
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Old 09-04-2013, 11:14 AM   #31
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Our experience obviously affect our biases, but I would not consider it based on my fathers experience with a hip replacement. Many problems and follow ups for 2 years including more surgery. I would hate to be caught up in constant travel across the planet on follow ups and corrective procedures.
I think this is a lot of it. Most medical procedures are simply not compartmentalized enough and combined with the luxury of a long pre-planning stage.

My good friend here in the Philippines wants to get a relatively simple outpatient medical procedure done but does not trust the docs for this particular procedure here in the Philippines. So he wants to get it done at Bumrungrad hospital in Bangkok.

But it is something like a 9 day commitment. Because, even if you arrange everything in advance over the phone and the internet, you must go in for a consultation. Then get the procedure done. There is the issue of ice packs and reduced mobility for a few days in an unfamiliar hotel room. And they want to have a follow-up about a week after the surgery.

And all this for something that is relatively uncomplicated and outpatient.

I guess my point is that it is often easier to recover at home, in familiar surroundings and with a support group.
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Old 09-04-2013, 11:16 AM   #32
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You know that site is satire, right?
Yes. Just thought I would add some humor to the discussion. We all know people who base big decisions on nothing but anecdotal evidence. "My great uncle Clint lost all his money in the crash of 1929, so I will never invest in the stock market." "Joe got post nasal drip after he had his gall-bladder removed, so I am going to keep my gall bladder, stones and all!"
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