Romney has been so cosseted and protected by many on our own side that he never went through the vetting process that other candidates have gone through. That is starting to happen now, and people are learning things about Romney they don’t like and don’t want in the next President of the US.

Most of his support as a candidate in this race has been based on two narratives, i.e. “electable” and “inevitable”. Both of these narratives that were used to cloud or to provide sugar-coated illusions of Romney’s true position on the issues. Those narratives are being stripped away, discarded and lost, perhaps forever. And for a lot of people, once those illusions were lost, their reasons to support Romney during the primary no longer exist.

How much impact this might have on the remainder of the primary season remains to be seen, but there is no basis on which can be assumed that Romney’s negatives are not deep seated when he didn’t have solid support on the basis of his positions pertaining to the issues to begin with.

expanding bureaucracy at either the federal or the state level, in consideration of Medicaid expansion, another viable option for some states may be to increase funding into public health entities and expand the range of services offered by these entities.

I know that it isn’t exactly a principle of Conservatism to consider public/private co-ops, but I think in this particular context it could drastically reduce the costs incurred at local ERs. And I’m saying that as someone who has actually been in a position to see the health records and incident rate of minor health problems coming through the ER.

Reducing the cost incurred to begin with could assist in collection activities. There are some “free riders” on the system, but for a lot of people, it simply ends up being a matter of available expendable income and cash on hand. The lower the expense, the more likely most patients are about working out some type of payment arrangement. But if the amount is large, it can be so daunting to the patient that they don’t even try.

Another idea that I’ve heard is for states to provide yearly capped vouchers for Medicaid expenses directly to individual consumers and allow the remaining amount of the voucher at the end of a year to be divided…part of it goes in cash to the individual and part of it goes into a HSA to be rolled over for future use in the event of catastrophic illness or major accident.

The rationale is that it would encourage individual consumers to become more cost-conscious. Rather than running to the ER, they might go to an urgent care center. Or if the situation is one where they could wait for a doctor’s appointment, it would keep them from running to the ER. If they have the sense that the “money” is their own….it could reduce costs by increasing individual accountability.

the profit margin ratio is going to become that much more important to hospitals, acat. I agree that claw-back rights are advantageous to these facilities, and placing them earlier in the process would be helpful.

I guess I’m looking at ways that they aren’t put in situations of potentially incurring those debts to begin with…preventive and pre-emptive actions, so to speak, by finding some means to provide other avenues of care. If it weren’t for that, I probably wouldn’t even consider any type of public/private co-op.

That was huge turning point in health care history, and I’m not sure how or even if that could be changed.

I do wonder if we might have options that would encourage health care providers to become more proactively involved in charitable donation of their services. There are those who do so out of the generosity of their hearts, but…do you think there’s any possibility that something along the lines of a tax-break incentive could be offered to private health care providers who volunteer for public health activities as a way of providing an alternative means of care? I’ve heard it mentioned once or twice, but really don’t know how viable an option it would be.

earlier today, I asked RMJ about the many “the Secretary will determine” provisions under O-care and whether the rulings that have been made under Sebelius could be altered if there is a change in leadership from D to R in Nov. And I was thinking about it in the context of altering those rulings in a way that would favor free-market options. RMJ said he believes that this would be possible.

If that is true, then if we do not succeed in obtaining full repeal of the law, it is still possible that we could turn this law on its head (so to speak) by utilizing the “Secretary” provisions.

That being the case, my ever-so-inquisitive mind has started wondering about how many different options we might have, both at the federal and the state level.

Tort reform, can take place at a state level, correct? Tort reform, per se, isn’t included in O-care, but if tort reform takes place, how many other doors of opportunity, that might be accessed via the “Secretary” provisions, would it open?

I would much prefer the push for full repeal so that we don’t have this monstrosity hanging out there in the wind for elected officials to play “political football” with it ever time there is a leadership change.

On the other hand, if by some chance we get an R President in 2012 and we don’t have the votes in Congress necessary for full repeal…turning this law on its head and throwing in all the free-market options we can find could ultimately bring about some major changes, couldn’t it? Pursuing it at this time could have advantages where generating growth in the private sector is concerned, too. And it would provide a huge contrast of R approach to D approach during the general.

Oh, BTW, RMJ’s take was that if Repubs went “full metal Neanderthal” (love his choice of his words there, don’t you?) on this matter, then it could very will bring it about for Dems to pursue court action that would eliminate the “Secretary” provisions. I think RMJ may be onto something there….wondering if they’d want to get rid of it enough to contribute a repeal effort….rather than watching Rs use it to implement more free-market options….

The number of ways in which the health care industry has been utilizing new technologies is a totally fascinating subject! From inpatient surgery to what is now outpatient surgery and beyond, the advancement of technology has been amazing.

We’ve already started losing a few hospitals via consolidation. Also, there are some more rural areas where hospitals were financially supported by municipal bonds that have closed.

I’m not sure how much altering the context where health insurance regulating what hospital a person can or can not use would change the environment to become more competitive amongst care providers. It might alter it some, but I think the methodology for defining reimbursement rates (coming from third-party payers) would have to change before we’d get close to see anything like a “price war”.