haha, there was no IV antibiotics. they did a blood draw and left the thing in there. I guess it was in case they wanted to IV the antibiotics. but after sitting there for 2 hrs, I figured they werent going to give me the IV version.

Seeing reports everywhere that the individual mandate repeal WILL be in the tax bill.

glgl

I mean, that can't pass the Parliamentarian, right?

Lawl, they're basically trying to sneak it in and be as quiet about it as possible.

$25 billion in Medicare cuts immediately

lol Trump-voting olds, now you get to die quicker

It already did last time? Mandate repeal is basically a tax cut anyway.

Link?

Maybe they've decided that since it looks like they're gonna lose control in 2018 they might as well just **** over everybody they can since the same dopes will vote for them again in 2020 when they convince them it was really the Democrats that sent their taxes through the roof.

Yep, going out anyway, so might as well set-up yourself up to get paid big $$$$$ as a "consultant" by the uber-wealthy that you just gave trillions of tax cuts to.

And once again, the only people that can save us from yet another Obamacare repeal, along with a tax bill that is personally going to raise my taxes by a few thousand dollars next year are John McCain, Lisa Murkowski, and Susan Collins. God help us. Edit: Susan Collins legit got cheered at an airport last time around, I don't think she's voting for it, so it comes down to Murkowski and McCain.

This can't be right. Blood draw needles and IV's are two different things. If it was in there for 2 hours it was an IV.

Well, them and the Byrd bath.

?

Nope. If the ER nurse is reasonably competent, she puts in at least an 18 gauge IV catheter and the draws off the line. Works fine. (If you use a smaller cath, you get hemolysis when you draw and it screws up the results - but if you draw slowly you can even pull off a 20, which is pretty small - they do it in kids all the time to minimize the number of sticks)

MM MD

i havent logged in and looked aroundcyet but they sent me a letter saying my permium was going up $300/month next year.

Doesn't the House version still violate the Byrd rules for the Senate for reconciliation? I think the Obamacare stuff would make that even tougher, but I could be wrong.

I'd bet big money that if it comes to the Parliamentarian, the individual mandate gets waved through. (Remember, the Supreme Court upheld the mandate. As a tax.)

Doesn't mean I think this is good policy. It's ten pounds of derp in a five-pound bag.

Reducing the penalty to zero seems like it passes the parliamentarian. Murkowski is putting in a bunch of stuff about arctic drilling that seems like a huge reach in that regard, however.

You would, unfortunately, be very, very wrong. A report for one client I looked at today was 40% of ER visits were unnecessary. Now, I get that that's looking at it afterwards and some of those people really thought they needed to go to the ER, but it's depressing. We have many frequent fliers that go to the ER 10+ times in a year. And they don't necessarily have co-morbids indicating a need to go. The best story was a few years ago some guy had a crush on an ER nurse and had over 40 visits to the ER.

I'm curious about the analysis you saw hobbes. From everything we've looked at, we're still actively trying to move people to urgent care and 24/7 settings. We are very much trying to move people out of the ER from a financial perspective. So it's curious that someone said the direct opposite.

Nah, you misunderstand.

From the PATIENTS point of view it's a logical use of their time, and they get worked up more efficiently - that doesn't mean it's in the best interest of the health care system for them to do it.

The problem isn't with the guy with a crush on the ER nurse - that's the same sort of nonsense that people use by finding someone abusing the welfare system and ranting about welfare queens. The problem lies that the system as it stands does a piss poor job of delivering primary care to people in any sort of reasonable manner, ESPECIALLY if you're un/underinsured. Kaiser does a pretty good job of it, but by definition all of their patients have coverage. Gets trickier when you don't.

Also, I firmly believe that acute abdominal pain/chest pain belongs at a minimum in an UC and probably an ER and not a primary providers office - and most health care systems agree, given the push to litigate poor outcomes not only on failure to diagnose but also failure to TIMELY diagnose a problem. A primary care doc simply doesn't have the hardware/lab capacity to work up any sort of significant medical urgency/emergency.

Note that I'm not defending the current system - it's a mess. I'd much rather be dealing with "Sick" patients that the worried well. I just got off a shift where I saw 15 patients, admitted 12 of them, intubated two and dropped a couple of central lines. Great shift. I only had one patient who I thought was "abusing" the system, and there were some psychosocial issues there that made it at least somewhat understandable. But ER "abuse" is very much in the eye of the beholder in a lot of cases.....

Lastly, the "people" trying to move patients to UC/24-7 settings are not all on the sides of the angels. Some are. Some are trying to maximize income for a for-profit heath care system, and lets just say the patients can end up holding the brown end of the stick. And for profit health care is a whole 'nother discussion.

MM MD

Is the individual mandate still in place or no? Is it on the chopping block? I thought the GOP healthcare reform was defeated. Is it back again?

It's in the Senate bill. It's not in the House bill that passed. If the Senate bill passes in its current form, they'll go behind closed doors and work out a compromise that could have it or not.

edit: hobbes described it better

http://www.independent.co.uk/news/wo...-a8062231.html