2012 Elections in the USA

[QUOTE=Doppelganger; 421941]You asked for more and I gave you the direct link to the source Medicare coding provided by the program. If you will look at the information provided earlier via the link you will find what you are looking for regarding Medicare's failure to pay for specific items. Since you don't understand the material the effort is lost on you. It is not my job to provide instruction unless you wish to pay my base rate for consulting.

I guess you now consider a chest x-ray to be a non-essential test to follow up on lung cancer, providing in your words 'no significant benefit'? This was one of the 'imaging' examples given.[/QUOTE]Doppel, the link you provided is simply a listing of codes and descriptions, grouped into categories. The file does not provide any explanation or reason for the various changes. These codes undergo changes every year. I am indeed familiar with most of the terminology in the file. Presumably you are referring to the following line:

[QUOTE]The following APC (s) were deleted from the IOCE, effective 01-01-12.
00307 Myocardial Positron Emission Tomography (PET) imaging[/QUOTE]Please confirm this is the service you believe has been dropped by CMS. Do you have a single shred of evidence that imaging services for Medicare recipients have been dropped [u]because of the Affordable Care Act[/u]?

Esten, I have to give you credit, you at least looked at the information, sort of. Again we are back at the point of you not understanding the material or medical coding.

I will make this simple so even a liberal can understand. Procedure codes which still appear must be linked with diagnostic codes. While a specific procedure code maybe paid when submitted with one diagnostic code it may not be when submitted with another diagnostic code. Understand? The cuts are made by removing procedure codes and / or diagnostic codes from what will be paid.

Now is there a specific listing from all the procedure and diagnostic codes which have been eliminated by ObamaCare? Of course not and if you don't know this you should. They are not about to publish a listing of specific care cuts, makes it too easy for people to target them and complain. What Medicare / CMS does is publish the revised lists each year and each specialty and / or healthcare service provider reviews what is or is not paid based on the scope of services provided and the associated diagnostic and procedure codes used to bill. Third parties usually ferret out the minutia and publish for specific providers.

If you think this is sneaky and convoluted, your right! This is how it works and how the shell game is played by Federal Healthcare.

Sorry your stab at the procedure regarding the heart condition was not very close and do you now understand the other half of the question you have not answered? I am disappointed you did not address the chest x-ray, it should have been very easy to located.

Have you noticed the new filings for unemployment are up again. Guess all those folks BLS dropped from the rolls are out looking again and pestering the government for payments.

BLS can erase them from being counted in the national unemployment rate but they can't stop them from showing up November 6th to vote the Blamer in Chief out of office

[QUOTE=Doppelganger;422011]Now is there a specific listing from all the procedure and diagnostic codes which have been eliminated by ObamaCare? Of course not[/QUOTE]Well well. So you don't have any evidence.

[QUOTE]If you think this is sneaky and convoluted, your right![/QUOTE]The only thing sneaky and convoluted is your attempt to save face in being unable to support your original claim. You've offered no evidence that PPACA has dropped medical imaging coverage for Medicare recipients.

[QUOTE=Doppelganger;421864]80 year old female diagnosed with a cancerous spot in the lung, a lifelong NON-Smoker, had surgery two years ago to remove upper lobe of one lung. The physician recommends annual imaging of the lungs to monitor any further activity, yes you guessed it, it's no longer paid for. Again the physician can order it but the patient now has to pay for it.[/QUOTE]Hmmm, blame it on "Obamacare"? Or maybe just a prudent measure to manage costs and allocate spending to maximize medical benefit?

Annual Screening With Chest X-Ray Does Not Reduce Rate of Lung Cancer Deaths, Study Finds
[url]http://www.sciencedaily.com/releases/2011/10/111026143717.htm[/url]

[QUOTE]In a trial that included more than 150,000 participants, those who underwent annual chest radiographic screening for up to 4 years did not have a significantly lower rate of death from lung cancer compared to participants who were not screened, according to a study in the November 2 issue of JAMA. The study is being published early online to coincide with its presentation at the annual meeting of the American College of Chest Physicians (CHEST 2011).[/QUOTE]Note the accompanying editorial:

[QUOTE]In an accompanying editorial, Harold C. Sox, M. D, of Dartmouth Medical School, West Lebanon, N. H, comments on the findings of this study.

"The PLCO lung cancer study result provides convincing evidence that lung cancer screening with chest radiography is not effective. The study is important for putting this question to rest and providing strong empirical grounds for comparing low-dose computed tomography to a real-world alternative: usual care.[/QUOTE]

Smoke and mirrors again Esten.

If you took the time to read your cited study it deals with general population sampling and not with patients who have undergone surgical intervention and / or previous diagnosis of lung cancer. Pretty poor example of your reasoning but typical for a liberal.

Occurence vs. recurrence? Merely different by an additional risk factor. Yes perhaps the ideal study addressing your example would have focused on populations previously diagnosed and treated for lung cancer. However the study I cited is far from irrelevant to this population. It highlights the limitations of chest x-ray to visualize early cancers, including a high false positive rate.

Perhaps you'll find this more convincing:

Utility of screening procedures for detecting recurrence of disease after complete response in patients with small cell lung carcinoma
[url]http://www.ncbi.nlm.nih.gov/pubmed/9264350[/url]

[QUOTE]CONCLUSIONS: These data, demonstrating that clinical histories and physical examinations are the most fruitful means of detecting evidence of recurrent lung carcinoma, are consistent with data regarding the follow-up of other curatively treated cancers, such as breast carcinoma and melanoma. Chest X-rays in asymptomatic patients detect recurrences in a small proportion of patients, whereas routine blood tests appear to be of little value.[/QUOTE]No medical organization recommends chest x-ray for lung cancer screening in asymptomatic persons, and several in fact recommend [u]against[/u] it (Table 1):
[url]http://www.dcmsonline.org/jax-medicine/2007journals/CancerScreening/lung_cancer_screening.pdf[/url]

Which really begs the question: Do you have any evidence Medicare has EVER covered annual chest x-ray for monitoring lung cancer recurrence ?

Esten, read what you post links to. Chest X-Rays for lung cancer screening does not reduce mortality when the cancer is found in it's late stages. Duh!

Chest X-Ray is still one of the primary tools used to diagnose the condition in its early stages when it is treatable. Chest-X Rays are also used to monitor as well as MRI for post surgical, radiation therapy and other treatment s used for lung cancer. Here is a link for you.

[url]http://www.cancer.gov/newscenter/pressreleases/2005/plcolungbaseline[/url]

If you want the last word in the conversation go to the MD Anderson site, after all they are one of the leading cancer research and treatment hospitals in the nation.

I guess the next thing you are going to tell me is ObamaCare is not gutting the Medicare Advantage program, which the Democrats passed additional funding for the Advantage program so cuts won't kink in during an election year.

This is all going to be a moot point in June when ObamaCare is struck down by the Supreme Court. Wonder how the Anointed One is going to handle the double whammy of the Court slapping down his healthcare grab and upholding Arizona's immigration law?

Monger on Dude!

[QUOTE=Doppelganger;422079]Wonder how the Anointed One is going to handle the double whammy of the Court slapping down his healthcare grab and upholding Arizona's immigration law?[/QUOTE]That's an easy one.

1. It's the Supreme Court's fault.

2. It's Congress' fault.

3. It's George Bush's fault.

Thanks,

Jackson

I love the way the BLS reports the new 'drop' in unemployment from 8. 2% to 8. 1, while the real rate is still over 14% The Wall Street Journal lays it out pretty simply, here is the link:

[url]http://blogs.wsj.com/economics/2012/05/04/why-did-the-unemployment-rate-drop-7/[/url]

A good analogy of the BLS's reasoning when it comes to unemployment would be:

As the Titanic is sinking. 60% of the ship is underwater, but then the ship breaks in half and the portion under water slips away leaving the other half sill sinking but now more out of the water than under.

BLS would say we are no longer 60% under water we are only 10% under since we are not counting the half that just broke off!

Just as BLS is not counting the folks who are long term unemployed and ran out of benefits, but are still unemployed and wanting a job.

When I was forecasting in the early 2000s, the decline of the labor force was a major topic. We thought labor was going to have to be more productive to support a larger population that did not work. I think the rise of internet retailing for example has eliminated many of the unproductive jobs in the economy. Your former bookstore or retail video clerk is probably peddling coffee now."Anything to eat with that?" Active duty military has also increased by 100, 000 since 2000 and I do not think they are included in the labor force number. I surmise that in 2030 that labor force participation will be smaller than today's number no matter who is in charge just like we forecast in 2000. However, no forecaster I have ever read would have projected such a long recovery in 2000. Rogoff and Rinehart probably came closest in "This Time Is Different: Eight Centuries of Financial Folly" but that was published in September 2009. The long recovery in my mind has hastened the decline in labor rate participation.

Saw Obama explaining how great the economy is. In about 6 months Obama will be looking for a job with his resume highlighting a GED / high school equivalency diploma. Undoubtedly. thanks to obama's great economy, Obama will join the ranks of the long term unemployed. A relatively new classification of workers gracias a Obama.

Long-term unemployed is just a statistician's term. In the old days we called them housewives.

Here's quote from a CNN article today."Jason Everett, for example, wouldn't be counted. Out of work for nearly three years now, Everett has given up his job search altogether. Instead, the unemployed plumber and Air Force veteran takes a few community college courses and looks after his two children while his wife is the primary breadwinner."

Oh BTW, according to this article these services are worth $60k to $115k.

[url]http://moneyland.time.com/2012/04/30/a-moms-work-is-worth-113k-annually-or-maybe-about-half-that/[/url]

I think this number is high given average household income is around $50k but I think Mitt believes it.

Personally I think our choice is between Tweedledee and Tweedledum for President this year. So the best course is to vote your pocketbook. If you live in high tax and high real estate value state you vote Obama. Low tax and real estate value states vote Romney. Reason: Obama will cater to special interests. Romney will want to flatten tax rates but he will lower tax expenditures to accomplish it. Life is simple when you look at it from the standpoint of your wallet.

[QUOTE=Big Boss Man; 422092]Personally I think our choice is between Tweedledee and Tweedledum for President this year.[/quote]I sort of agree. Of course, I am retired and am not looking for a job. It won't bother me too much if Obama is re-elected. It is just that Obama appears so clueless about a free market economy and the benefits of a free market economy. Not surprising, might I add, considering Obama has never had a real job in his life.

There are many worthwhile discussion points in the Patient Protection and Affordable Care Act (PPACA). The law has a big focus on disease prevention and early detection, essential to controlling health care costs. I suspect we'll be hearing more about the benefits of the law in the election campaign.

One of the things the law did was prohibit co-pays for preventive services recommended by an independent expert panel, the United States Preventive Services Task Force (USPSTF). The law also makes proven preventive services free for most people on Medicare. Listed below are cancer screening services for which co-pays are prohibited (at defined ages). Chest x-ray screening for lung cancer isn't included, because it hasn't proven to be cost effective. There are significant costs associated with the high false positive rate.

- colonoscopy for colon cancer.
- Pap smears for cervical cancer
- mammograms for breast cancer.

In his zeal to attack the new health care law, Doppel claimed that Medicare chest x-ray screening for lung cancer recurrence had been dropped by PPACA, implying it was a victim of $500 Billion in Medicare "cuts" to help expand Medicaid. As I posted before, there are $500 Billion of savings in future Medicare spending in the next 10 years, but not from cutting benefits. But it gets better. Doppel couldn't even prove Medicare had EVER covered this service. It's probably because no medical organization (including the USPSTF) recommends it for asymptomatic people. If you don't have symptoms, it's a "waste of time" according to the American Cancer Society.

Doppel dug himself in with a great deal of deflection and bluster, but his original claim has been exposed as false.