Market politics

[neroden]

Why would we want medical procedures to be evaluated rather then just blindly paying for them. Like Medicare does.

"Medical research published in The New England Journal of Medicine in 2010 -- six years before her diagnosis -- showed that a condensed, three-week radiation course works just as well as the longer regimen. A year later, the American Society for Radiation Oncology, which writes medical guidelines, endorsed the shorter course."

How unnecessary tests, scans, procedures and surgeries are affecting your patients

Medicare is a bit old-school, with its 80/20 design. Medicaid does evaluate procedures, for real. So does our National Institutes of Health. So does the National Health Service in Britain. So does the VA.

So, sure, let's go with Medicaid or the VA for everyone, instead of Medicare. Cool, good idea.

Private insurance companies don't really evaluate procedures. They just look for excuses to reject payment.

You're deflecting. The fact is that for all this money private insurance companies spend they get WORSE OUTCOMES, and this is documented by EVERY STUDY EVER.

 

[EVNow]

Most people haven't even *heard* of Buttigieg (and most of those who have can't spell his name) and he's running at +4%? Wow.

Yes - basically there are some 50%+ people who say they just won't vote for Trump. Unless Dems completely screwup (quite possible), Trump can't get re-elected.

Every time Trump has a chance to expand his appeal, he keeps falling back on his base. For eg. there was zero reason to try to get back to scrapping ACA now, soon after positive news from Mueller, but he is trying that now.

 

[Steve m]

Maybe we should ask the government?

From an NIH report

The response rate was 70.1%. Physicians reported that an interpolated median of 20.6% of overall medical care was unnecessary, including 22.0% of prescription medications, 24.9% of tests, and 11.1% of procedures. The most common cited reasons for overtreatment were fear of malpractice (84.7%), patient pressure/request (59.0%), and difficulty accessing medical records (38.2%). Potential solutions identified were training residents on appropriateness criteria (55.2%), easy access to outside health records (52.0%), and more practice guidelines (51.5%). Most respondents (70.8%) believed that physicians are more likely to perform unnecessary procedures when they profit from them. Most respondents believed that de-emphasizing fee-for-service physician compensation would reduce health care utilization and costs"

Overtreatment in the United States

 

[Steve m]

Scientific America

[During a pre-operative visit, the surgeon offered to throw in a surprising perk. Should we pierce her ears while she’s under?

O’Neill’s first thought was that her daughter seemed a bit young to have her ears pierced. Her second: Why was a surgeon offering to do this? Wasn’t that something done free at the mall with the purchase of a starter set of earrings?

“That’s so funny,” O’Neill recalled saying. “I didn’t think you did ear piercings.”]

Added cost $1800 more then picking a non black color for your model 3

Unnecessary Tests and Treatment Explain Why Health Care Costs So Much

 

[EVNow]

Something interesting about 2020 primary.

In her home state Warren is placed 3rd.

Warren places third in 2020 Massachusetts poll

 

[dmckinstry]

Yes - basically there are some 50%+ people who say they just won't vote for Trump. Unless Dems completely screwup (quite possible), Trump can't get re-elected.

Well over 50%+ people didn't vote for Trump in 2016. The problem is that many of that 50%+ didn't vote for anyone.

 

[neroden]

Most respondents believed that de-emphasizing fee-for-service physician compensation would reduce health care utilization and costs"

If you didn't know what that means, it means single payer would solve the problems.

Dude, read your own sources

 

[Steve m]

If you didn't know what that means, it means single payer would solve the problems.

Dude, read your own sources

Wrong.

Medicare actually pays out on a fee for service basis.

Kiaser for example is a health maintenance organization.

There are more then two options!

 

[Steve m]

As many as 42 percent of U.S. Medicare patients were subjected to procedures providing little if any medical benefit, costing the government program up to $8.5 billion in wasteful spending, according to a study published on Monday.

Medicare pays billions of dollars for wasteful procedures -study

 

[neroden]

Wrong.

Medicare actually pays out on a fee for service basis.

Medicaid and the VA are examples of single-payer systems

Like I already said

I'm going to report your comments for refusal to pay attention

For the peanut gallery, I'll point out that private insurers do WORSE than Medicare (go down to exhibit 3 and note the disproportionate increase in hospital billing for private insurers):
https://www.healthaffairs.org/do/10.1377/hblog20180530.245587/full/

And, as Kenneth Thorpe has observed, the underlying drivers of spending growth “differ sharply by the source of health insurance,” with enrollment and disease prevalence the major factors for Medicare and Medicaid, while the cost of individual cases is the primary culprit in the privately insured population. Detailed analysis of private claims confirms this latter point, finding relatively flat usage of most health services from 2012 to 2016, with price hikes explaining most of the overall cost increase.

Medicare is handling more and sicker people each year.

Private insurance is just paying more for the same people with the same amount of health needs each year. It's broken.

If we compare their reported figures to overall health consumption expenditures (HCEs) by certain payer types, the Berwick and Hackbarth assessment found waste on the order of 31 percent of HCEs within Medicare and Medicaid, but 41 percent across the rest of the system, which is predominantly funded through private insurers. Waste rooted in administrative complexity—estimated at 14 percent of private payer outlays—accounts for the bulk of the difference. Berwick and Hackbarth’s conclusion is supported by other research in this area.

https://www.healthaffairs.org/do/10.1377/hblog20180530.245587/full/Exhibit4.png

 

[defc0n]

Something interesting about 2020 primary.

In her home state Warren is placed 3rd.

Warren places third in 2020 Massachusetts poll

You might say she is 0/1024th president

 

[neroden]

I think Warren is more useful in the Senate, frankly.

 

[Steve m]

Done. It's boring listening to reality deniers. I gave you some links showing that private insurers are the biggest drivers of spiralling health costs. You don't want to listen.

Biggest drivers of spiralling healthcare costs...

Talk about dening reality... There are several others that you ignore.

9 Drivers of High Healthcare Costs in the U.S.: In 2012, healthcare costs per person averaged almost $9,000, a monumental increase from 2007, when healthcare per capita hovered around $7,600.

 

[Steve m]

https://www.healthaffairs.org/do/10.1377/hblog20180530.245587/full/

Look at exhibit 4.

Healthcare spending increased 632 billion over 5 years. Of which 74 billion was insurace companies while 231 billion was hospitals and 129 billion was physicians and clinics. Ok so what was the biggest driver in healthcare costs again?

 

[Right_Said_Fred]

With this discussion on healthcare not going anywhere and the quality of posts deteriorating, let's put an end to it. Any more posts on this subject will be removed.

Mod

OtherMod: at the same time I moved a couple of posts that contained nothing but insults to snippiness. Keep it civil. --ggr.

 

[SeminoleFSU]

You doubt and discount the "quiet trumpsters" at your own peril. I suspect there are a lot of people out there who voted, and may very well vote again, for Trump but would never admit it. He has followed Herman Cain in finding and appealing to our dark underbelly; he is just doing a better job of it than Cain did.

I think he might go down as one of the best presidents in the history of our nation. I say that as a Libertarian that does not agree with all his decisions, but at least it appears his decisions are grounded in a LOVE for our country. I can't say the same for his predecessors (including some of the Republicans)

 

[JRP3]

It's should be obvious that his decisions are a combination of random events, a love for himself, and pandering to his base. History will see him for what he was. Assuming there is a future to look back from.

 

[lolachampcar]

Love of $
Full stop
He would not know a country if it bit him in the genitals

 

[Unpilot]

I think he might go down as one of the best presidents in the history of our nation. I say that as a Libertarian that does not agree with all his decisions, but at least it appears his decisions are grounded in a LOVE for our country. I can't say the same for his predecessors (including some of the Republicans)

He wraps hiself in the flag...yet did not serve when called.
He trumpets his charity to vetrans yet did not pay till forced to by the media.

Yeah he is a true Patriot alright.

 

[SeminoleFSU]

He wraps hiself in the flag...yet did not serve when called.
He trumpets his charity to vetrans yet did not pay till forced to by the media.

Yeah he is a true Patriot alright.

Yup. I wouldn't fight in stupid wars for (central banker) profit either if I could avoid it. Didn't hear you guys complaining about draft dodging while Clinton was in office though!