Coronavirus

[SageBrush]

I read that after our glorious and supreme leaders infection the government ministers (specifically the Chancellor) were not going to bother with self isolation

I was getting bored by all the extrapolation chatter from cruise ship data. Soon we can have the 'Parliament' model

 

[AlanSubie4Life]

Therefore, to estimate the IFR, we used the estimate from Germany’s current data 22nd March (93 deaths 23129) cases); CFR 0.57% (95% CI, 0.50% to 0.65%) and halved this for the IFR of 0.29% (95% CI, 0.25% to 0.33%) based on the assumption that half the cases go undetected by testing and none of this group dies."

Lol.

on March 26 they added the Icelandic analysis with an estimate of 0.05-0.14%. They said the Icelandic data will likely provide an accurate estimate of CFR and IFR:

"Iceland’s higher rates of testing, the smaller population, and their ability to ascertain all those with Sars-CoV-2 means they will likely provide an accurate estimate of the CFR and the IFR. Current data from Iceland suggests the IFR is somewhere between 0.05% and 0.14%."

I am sure they are looking at the sampling bias on that population sample from Iceland with the rigor they displayed when looking at the German data.

 

[bkp_duke]

Here in the UK we have a treatment for all, universal healthcare system, loved by the entire nation (Think similar ratings to soldiers - is that the same in the USA?) which costs less than half what the US pays for partial coverage.

Stay safe as well. I will, respectfully, disagree. While on face value in the UK you can get your treatment for all conditions, it is a system under significant stress with much longer wait times (prior to the current crisis, which reset everything in every nation) than the US system.

Britain's Version Of 'Medicare For All' Is Struggling With Long Waits For Care
https://www.dailymail.co.uk/health/...hours-Englands-worst-performing-casualty.html
NHS Key Statistics: England, February 2020

There are arguments to be had on both sides on this, but there is a growing body of data that shows the UK and other socialists systems are straining under an aging population, with wait times for care going up substantially. That is coming out in the data as lower survival rates (the above article gives examples of breast and prostate cancer, being much lower in the UK than the US).

 

[Florafauna]

I was getting bored by all the extrapolation chatter from cruise ship data. Soon we can have the 'Parliament' model

We have a very utopian society here - the plan is for everyone to get infected regardless of race, religion or political persuasion.

Lovely.

 

[SDRick]

You also have to tightly control those that come in contact with those most at risk.

Or get them to wear masks and wash hands with diligence.

That kind of goes without saying.
Sounds comparatively easy compared to the other things being done to address the situation.

 

[Oil4AsphaultOnly]

My reply is not to advocate for insurance companies. And I am sure your experience was a miserable one.

I have literally wasted years of my life on the phone arguing the medical necessity of a procedure or test for a patient . . . with a bean counter with no medical training on the other end reading from a script. I am no fan of insurance companies, nor the owners of hospital systems. I think the US healthcare system can be FAR better. But I am a HUGE skeptic of putting that kind of power in the government's hands to determine for us (i.e. socialized medicine). Just look how far the current pandemic here has been screwed up by our government (Trump aside, there are multiple layers of screw-ups, from the CDC on down).

I fully expect to get disagreed on this post, but those that have read my posts in the market politics thread know that I am an advocate for removing the small, individual, regional monopolies that plague the US healthcare system. Specifically, stop letting one or a few insurance providers sell in just a single state (i.e. allow anyone in the US to buy any policy, from any company, in any state). Additionally, hospitals, providers, etc. should be FORCED to publish their prices. Right now, there is nearly ZERO price transparency for anything in the healthcare system here. That lack of transparency lets prices run amok and increase with no counterbalance (i.e. competition). If prices were published, and hospitals had to compete for services, not only would prices decrease, but the quality of good would increase.

It's only when companies and systems are allowed to become monopolies that we have serious issues with cost and quality.

My 0.02. Feel free to disagree.

i agree with your call for transparency, but that makes your aversion to single payer even more silly. having a single payer means being able to dictate transparency!

But the doctors office does tell us what the cost of a procedure will be, before we agree to it. just like a mechanic gives you an estimate before the repair work starts. The only difference is we don't know what our costs (as a patient) are without them checking to see which insurance policy we're under (due to different co-pays and deductibles). That fault lies solely on the multitude of insurance programs.

 

[Florafauna]

Stay safe as well. I will, respectfully, disagree. While on face value in the UK you can get your treatment for all conditions, it is a system under significant stress with much longer wait times (prior to the current crisis, which reset everything in every nation) than the US system.

Britain's Version Of 'Medicare For All' Is Struggling With Long Waits For Care
A third of A&E patients are waiting longer than four hours at England's worst-performing casualty | Daily Mail Online
NHS Key Statistics: England, February 2020

There are arguments to be had on both sides on this, but there is a growing body of data that shows the UK and other socialists systems are straining under an aging population, with wait times for care going up substantially. That is coming out in the data as lower survival rates (the above article gives examples of breast and prostate cancer, being much lower in the UK than the US).

I certainly agree that (I only have knowledge of) the UK system is straining under increasing demand. My aged family have received exemplary treatment, however. The main strain, IMHO, is that we still don't spend anywhere near enough money on it. To do that (to get expenditure closer to the US) will require less spending on other things.
Difficult choices, but there is a fairly united view (across Left AND right) that more expenditure is a good thing.
It is a shame that the US doesn't have that same unity.

Maybe one ray of light in the Coronavirus crisis might be better agreement on how to improve healthcare for all - whatever the system.

 

[Lessmog]

In a tiny way yes, they are related. Osvaldo Cruz changed its name from California to the present one in homenagem to Cruz, according to the Wiki. FWIW, Oswaldo Cruz started in his post MD work with Louis Pasteur working on developing the germ theory. he subsequently did pioneering work in epidemiology and disease vectors that paralleled the work being done in Europe by, mostly, other Pasteur-influenced people. We have that group of pioneers to thank for the present state of immunology, epidemiology, parasitology and numerous other related disciplines.

Lucky for me one of the most thoughtful people I ever met taught History of Science. He devoutly believed that "those who fail to learn the lessons of history are doomed to repeat them". I wonder how many times the world must endure one epidemic after another and still so relentless ignore being prepared. Just now I am feeling reflective as so many world leaders are so disastrously ignoring facts.

The genius President Bolsonaro has declared churches as 'essential services' and is encouraging people to gather together in churches to pray. Thus far few people have heeded him, but the weekend is coming.

Lest we forget: spread from Wuhan to South Korea came through a huge religious convention. The first large breakout near New York City happened within an insular religious community. Major parts of outbreaks in Italy and Spain happened with religious gatherings in retirement communities. For at least 130 years we have known that communicable disease spread most efficiently within large closely packed groups. Social distancing works. Now we have at least two Presidents pretending that religious gatherings are self-protective or protected by their diety.

Decades ago I was in Banares (Varansi) looking at the funeral pyres and assorted pollutants in the Ganges. My devout friend told me none fo those pollutants could affect people because the river was a holy river thus was purified.

Denial of the seriousness and spread of this virus is no different. People are happy to deny truth if they disbelieve in science. Today more and more influential people disbelieve in science. The world is paying a high price for willful ignorance.

end rant.

And futebol! /But I repeat yourself/

 

[bkp_duke]

i agree with your call for transparency, but that makes your aversion to single payer even more silly. having a single payer means being able to dictate transparency!

But the doctors office does tell us what the cost of a procedure will be, before we agree to it. just like a mechanic gives you an estimate before the repair work starts. The only difference is we don't know what our costs (as a patient) are without them checking to see which insurance policy we're under (due to different co-pays and deductibles). That fault lies solely on the multitude of insurance programs.

This is patently false. The Doctors office first ASKS you what your insurance is. The cost of the procedure / treatment / office visit is dictated by the contract between the doctor and your insurance provider. As you know it, you just have a co-pay or deductible to meet, but that's now how the process actually works when you look at the system as a whole.

Take that power away from insurance companies by forcing the publication of prices, and the entire landscape becomes MUCH more competitive and cost effective.

Based upon years of practice both in an office and hospital setting, I can tell you that the rates vary not by a few %, but hundreds of %. Sometimes this is to the benefit of the hospital (almost never to the actual doctor), sometimes it is not.

I could be persuaded to allow the government to compete with insurance companies, and that would be good (it already happens in the pediatric space with Medicaid). But to allow the government to take it all over and dictate everything would be a colossal blunder.

 

[Daniel in SD]

Is there any correlation between severity of the outbreak and the type of health care system? Can't we have another thread to argue about health care?

 

[bkp_duke]

i agree with your call for transparency, but that makes your aversion to single payer even more silly. having a single payer means being able to dictate transparency!

Replying to this part separately. Please provide me an example of a government run entity providing service to the public, which "dictates" anything and that also runs efficiently and is not ripe for abuse.

DMV - nope
VA medical system - nope, been part of that, although it is improving

Do I even need to bring up the IRS?


We do not want the government in our healthcare, even though I see popular opinion pushing us there. If we go there, lives will be lost. The only way to maintain price controls in a socialized medicine system is to RATION CARE.


Do I even need to get into how many Drs will take early retirement if we went to a M4A system? No doc I know of likes dealing with medicare now, forget if it is forced upon them.

 

[bkp_duke]

Is there any correlation between severity of the outbreak and the type of health care system? Can't we have another thread to argue about health care?

In the current outbreak, no there is no correlation that I am aware of at this time. It will be interested to see if anyone publishes that data.


I've said my peace, and I feel it was in reply to those using the current thread to tangentially push for M4A. Over-arching point: M4A is not the grand panacea that it is sold to us to be.

 

[EVNow]

From the Guardian...not exactly a Conservative publication: She's a legend in the fight against HIV. Now Dr Deborah Birx is taking on Covid-19

Neither Birx (clinitian) nor Fauci (infectious disease expert) is an epidemiologist. Its ridiculous that they didn't include an epidemiologist to fight a pandemic - but par for the course.

 

[Oil4AsphaultOnly]

Replying to this part separately. Please provide me an example of a government run entity providing service to the public, which "dictates" anything and that also runs efficiently and is not ripe for abuse.

DMV - nope
VA medical system - nope, been part of that, although it is improving

Do I even need to bring up the IRS?


We do not want the government in our healthcare, even though I see popular opinion pushing us there. If we go there, lives will be lost. The only way to maintain price controls in a socialized medicine system is to RATION CARE.


Do I even need to get into how many Drs will take early retirement if we went to a M4A system? No doc I know of likes dealing with medicare now, forget if it is forced upon them.

that's a lot of contradictory requirements. any government run entity is almost universally expected to be less than fully efficient. they're only expected to be fair. Which would be a leg up against the current insurance system, which has many of the same drawbacks but includes being unfair to many.

 

[jhm]

Italy's growth factor looks a little more promising, but ICU trends are disturbing. Something to keep an eye on as a hint of where we might be heading in other hot spots.

View attachment 526385

View attachment 526384

Coronavirus Italia

Is the case growth factor based on just active cases? Otherwise if it is total cumulative cases, I don't understand how a factor <1 is mathematically possible. I do think that active cases is a better metric to follow to know what is stressing the health system and how many remain at risk of death from the infection.

 

[bkp_duke]

that's a lot of contradictory requirements. any government run entity is almost universally expected to be less than fully efficient. they're only expected to be fair. Which would be a leg up against the current insurance system, which has many of the same drawbacks but includes being unfair to many.

But US Gov entities do not have a track record for being fair . . . They often have significant political motivations. They should not, I agree, but they do sometimes depending upon the party in power.

 

[bkp_duke]

Tangential, but related note that some here might appreciate.

I've always been of the opinion that virtual office visits or "telemedicine" was under-utilized in the US. Much of that is due to an insurance and coding system (Gov side as well) that is not setup to account for proper billing for these kinds of patient encounters.

Due to the current pandemic, I've seen the use of telemedicine for existing patients skyrocket. I cannot advocate this for new patients, as the physical exam, when done by a competent physician, is a vital piece of information.

This should prove to be a significant cost and time-saving feature if allowed to continue once the current crisis passes.

 

[MXLRplus]

Neither Birx (clinitian) nor Fauci (infectious disease expert) is an epidemiologist. Its ridiculous that they didn't include an epidemiologist to fight a pandemic - but par for the course.

By that logic, you should only allow a chef to run ADM. Or a professional driver to run Tesla.
Read her bio.

 

[jhm]

I'm all for the President encouraging companies to increase ventilator production, but essentially rage tweeting? Unreal. If I'm not mistaken, isn't he the head of the administration that just backed out of a $1B procurement of 80,000 ventilators?

Donald J. Trump on Twitter

Is he invoking Defense Production Act powers in this Tweet?

 

[X Fan]

Neither Birx (clinitian) nor Fauci (infectious disease expert) is an epidemiologist. Its ridiculous that they didn't include an epidemiologist to fight a pandemic - but par for the course.

Sigh...how do you know they are not consulting with such?

I ran companies at the back end of my career.

I made decisions and had a varied set of inputs/expertise on my team (and although I held a number of discipline positions in my career prior to my roles as CEO/Chairman, please note that in my most Senior Roles, I relied on the expertise of others to round out my decision making).