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wow it's almost as if they had a century to figure out how to remove a useless organ under two inches of skin!

Oh wait, they did? Yet they still perform a medical theater show trying to find ways to avoid the simple operation?

https://psnet.ahrq.gov/webmm/c...
https://westjem.com/case-repor...
http://www.washington.edu/news...
Yeah, it's from 2001, but what happens when they miss appendicitis and fill you up with antibiotics because they decided it was something else?

before they start playing with DNA.
Modern medicine still can't get appendicitis right. Doctors look at unreliable scans to make life or death decisions...

https://psnet.ahrq.gov/webmm/c...
https://journalofethics.ama-as...
https://westjem.com/case-repor...

and my favorite

http://skepticalscalpel.blogsp...

Great job, guys. You can't even figure out a 19th century disease and now you want to play with the mechanics of life itself?

In any case, why is efficacy testing a bad thing? Shouldn't a drug be proven to actually treat the condition it's supposed to be treating?

Ask anyone that cant get a drug that works because testing for their rare condition will never be done because the drug also works for some common condition.

Good intentions for the sake of good intentions costs lives. Your policy is equivalent to murder.

That's what off label prescribing is for -- if your doctor thinks that a drug will treat your condition even if that's not the primary purpose of the drug, he can prescribe it for that condition. But drug companies shouldn't be allowed to shot-gun all of their drugs on the market without any proof that they treat any condition at all.

So call off the police, I haven't murdered any one.

Way to compare to a nonexistent zero state. 100 ambulance calls in 3.4 years for 10,000 employees is an incident rate of 2.9 per 1000 people per year.

The hospitalization rate for people aged 18-44 is 78.9 per 1000. The rate for people aged 45-65 is 108.8 per 1000. So the rate for ages 18-65 is 2 / (1/78.9 + 1/108.8) = 91.5 per 1000.

Basically you're advocating that Tesla employees should unionize because Tesla is mistreating them by keeping them 30x healthier at work than they are at home.

http://effectivehealthcare.ahr... solves this issue.

http://effectivehealthcare.ahr...

5% of the population (15 million people) account for 50% ($1 trillion) in spending.

http://www.ahrq.gov/research/ria19/expendria.htm

Anti-psychotics are an interesting class of drugs in their own right. That said, many drugs have uses other than their primary one.

http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=8&pageaction=displayproduct

As you can see there, some anti-psychotics are used to treat depression, OCD, and PTSD. Each of which, I believe represents a larger section of the population than people who are actually psychotic. I would not be surprised if the off label use in the larger population of those patients, could easily dwarf the real psychotics, or at least swell the numbers quite a bit.

And I do believe it to be somewhat common, a couple of times different people told me what medications they were on, and I looked them up to find out one was an anti-psychotic, that was being given for an off-label indication.

Buffet style insurance is a huge part of the problem. People don't see the costs of their health care, and they're accustomed to getting as much as they want (not need) for a set amount of money, much of which is paid "magically", "somehow" by their employer.

I'm not saying this is the entire problem, but it's a huge part of it.

No, in fact, it's not.

The bottom 50% of the population accounts for something in the order 3% of the health costs, while the top 5% account for about 49% (US government data). The bulk of people who are partaking of this "buffet" don't really cost a lot to cover; the seriously sick few are vastly more expensive. Imposing the high-deductible nonsense has the most effect on that 50% of the population who uses 3% of the healthcare. Yeah, that's gonna help a lot.

The other thing you are missing (and other people who make your argument) is that the incidence and cost of expensive health episodes is reduced by preventive care. Allowing people to go to the doctor today for cheap means that more potentially serious health conditions are detected early and managed for less cost. This is why detractors' typical analogies to car insurance are misguided: a car insurer that paid for your gas would be making it more likely that you'd have an accident (by incentivizing you to drive more). A health insurer that pays for your routine visits is making it less likely that you'll have a major health episode.

I also wanted to mention another little research article by AHRQ: Research in Action, Issue 19.

The intro does say that spending is unevenly distributed, but if you read the rest I think you'll find it backs up my previous post.

I agree that, fundamentally, insurance requires some people to pay more in premiums than they'll receive in benefits. But you're missing the massive overhead of covering routine expenses, versus the relative low overhead of covering only exceptional expenses. It's that overhead I want to avoid.

The routine stuff for healthy people is the cheap stuff, actually. Seriously, the bottom 50% of the population incurs 3% of the healthcare costs. The bottom 80% of the population accounts for 20% of the costs. If you kill off 25% of that in overheads, all you've saved overall is 5%.

If you really want to reduce costs, go after the stuff that's actually costly.

I also want to be able to choose my risk tolerance and weigh it against my lifestyle and personal health exposure.

Yeah. That's called adverse selection. Basically, you want to enroll in a plan that charges lower premiums because it doesn't admit sick people. Then if you get sick you'll act all surprised that when the plan kicks you out because it doesn't admit sick people.

I'm not claiming anything about spending; only health outcomes.

My main point is that five year cancer survival rates can be misleading, which you don't seem to have disputed.

Unnecessary screening and/or treatment can affect health outcomes. For prostate cancer, the U.S. Preventive Services Task Force recommends against screening for men aged 75 or older and says that there is insufficient evidence to make a recommendation regarding screening for those under 75. As for the harms of screening and treatment:

• The harms of screening include the discomfort of prostate biopsy and the psychological harm of false-positive test results.

• Harms of treatment include erectile dysfunction, urinary incontinence, bowel dysfunction, and death. A proportion of those treated, and possibly harmed, would never have developed cancer symptoms during their lifetime.

From the American Cancer Society:

The American Cancer Society (ACS) does not support routine testing for prostate cancer at this time. ACS does believe that health care professionals should discuss the potential benefits and limitations of prostate cancer early detection testing with men before any testing begins. This discussion should include an offer for testing with the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) yearly, beginning at age 50, to men who are at average risk of prostate cancer and have at least a 10-year life expectancy. Following this discussion, those men who favor testing should be tested. Men should actively take part in this decision by learning about prostate cancer and the pros and cons of early detection and treatment of prostate cancer.

I see. You are a tree hugging socialist liberal who obviously believes each individual European country should cease to exist and become a single homogonous nation, eliminating the unique, disparate legacy of each before joining the single, one world government which will take care of your every want and need. Right comrade? You also believe that the world should be able to tell you, regardless of where you live, how your country should be run and whether or not you can own something you may desire. The Kyoto (not Kioto) protocol (it was proposed in Kyoto, JP but you probably don't know anything about Japan, either.) http://en.wikipedia.org/wiki/Kyoto_Protocol attempts to do exactly this.

You are also apprently blessed with the misconception that the CO2 and other gases generated by the American population of automobiles in any way exceeds those the gases expelled by the worlds volcanoes in a single day. I think you might want to explore a significantly higher probability that we are exiting the last "Little Ice Age" http://en.wikipedia.org/wiki/Little_Ice_Age rather than experiencing global warming.

As for Socialism "taking care of you when" at the expense of all those remaining behind in the work force, those with a clue, a healthy income as a result of their decision to expend some hard work and getting an education and bank account choose to take care of themselves rather than expecting the government to do it for them. We also don't believe you have a right to a job just because an employer made the mistake of hiring you in the first place. In America, you actually have to EARN the OPPORTUNITY to have a job. Would I like to see some protection for those folks who have worked somewhere for 25 years from being laid off a month before their retirement? Sure. But I don't want to pay for welfare scumbags who worked as a bus boy for 20 years expecting handouts and helth care because they were too stupid to make a life for themselves. Personally, I would prefer to see their end of the gene pool, like yours, to get a bit shallower.

I will also put the healthcare available in the US ahead of anything you might have in Europe, Asia, Middle East, etc. (with a very few exceptions). And anyone without helthcare in the US can still walk into any emergency room in the US and will be treated, again, with significantly higher quality healthcare than what you are probably getting. I would have to examine a direct comparison of the quality of care where you are to what I know we are getting here http://www.qualitymeasures.ahrq.gov/.

Before you go google some report saying how crappy US healthcare is, I can tell you it will only apply to someone who can't afford it, which really doesn't bother me. I went to school, got a good job, and I pay for healthcare for my family. I have the right to do that in the US. I didn't come from a wealthy, white collar family. My divorced mother raised 3 kids with elective welfare to help support her raising 3 kids on her own. All 3 of us worked hard and supported our own way through college and we all have successful careers. I worked for everything I have today and I wouldn't trade the quality of life I have in the USA for whatever slime hole existence you choose to suffer through.

If you think you have any hope of convincing me, or the majority here of anything to the contrary, you are sadly mistaken. And anyone who truly believes their life would be better outside the US than is here today, I would personally support paying for a one way plane ticket and a taxi to the airport. Hasta la vista, baby. We don't want or need you here any way.

How much would that cost me compared to the total ammount I pay into insurance? Insurance is a gamble and these days it's a bad one. At $1000 / year plus 20% I think I'm better off having the hospital bill me in payment plans. In 2002 the average bill for a hospitalization was $17,300. So lets do some calculating:

Basic health care: $82 / month

Deductable: $3,500

Drugs (pain killers): $500 deductable (so I pay my drugs out of pocket)

Hospital care: 50% AFTER deductable

So if I have isurance for a year and then got hospitalized, I spend $984 in premiums + $3500 in deductable + 6,900 costs.

In all, in one year I will spend $11,384. Which means that if I can keep my hospital stays down to one every 7 years I will have beat the house.

Source for hospital info:
http://www.ahrq.gov/data/hcup/factbk6/factbk6b.htm #hospital

Source for insurance: BCBS

But of course, my main point was the insurance for basic health care. Simple doctors visits should NOT cost $100 per vist, but because of insurance being the way it is, doctors can get away with that.

The following is a description of the main conclusions from each of the seven categories of interest:

• Drug vs. drug comparisons: The limited evidence available from studies comparing different stimulants suggests that there are few, if any, short-term differences in effectiveness among methylphenidate (MPH), dextroamphetamine, and pemoline. The studies comparing stimulants to tricyclic antidepressants had many limitations and presented conflicting results.
• Drug vs. nondrug comparisons: Despite the limitations in the individual studies, the results indicate consistently that stimulants are more effective than nonpharmacological interventions when compared head-to-head.
• Combination therapies: There is a lack of evidence supporting the superiority of combination therapy over stimulant alone or superiority of combination therapy over nondrug intervention alone. A recent large trial found that combined treatment offers modest additional benefits over single-component treatments for non-ADHD areas of functioning.

Hey, you're right, and this idea worked so well for the energy industry!

http://www.enron.com/

And all this sort privitization is helping America's poor working class get such great access to health care!

http://www.ahrq.gov/qual/nhdr03/nhdrsum03.htm#Ineq uality

Listen: Atlas Shrugged is FICTION.

Actually, there has finally been some research completed recently that concludes: "The rate of serious medical errors committed by first-year doctors in training (interns) in two intensive care units (ICUs) at a Boston hospital fell significantly when traditional 30-hour-in-a-row extended work shifts were eliminated and when interns' continuous work schedule was limited to 16 hours". Press release here: http://www.ahrq.gov/news/press/pr2004/16hrintpr.ht m