Domain: healthaffairs.org
Stories and comments across the archive that link to healthaffairs.org.
Comments · 50
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Re:GOP marketing
The ACA wasn't created by "the left", it was the centrists in the Democratic party who pushed it, wanting something they believed (because they're idiots) Conservatives would support (which is why it's based upon Mitt Romney's 2004 proposals.) The left wanted single payer, and pushed for, at the very minimum, a government run insurer ("The Public Option") and were stymied because Joe Lieberman refused to allow the ACA to pass the Senate with his vote unless it was dropped.
The ACA is also only a tweaking of the existing system, still keeping the fundamental building blocks in place, so it's hard to see how it can be responsible for "most publicly traded insurance companies (seeing) their stock prices shoot through the roof". Regardless, blaming "the left" for this when the left wanted government competition to the insurers is absurd.
The left isn't using "the social safety net" to "buy votes" either but you'll never be convinced of that despite the fact it's pretty obviously left wing ideology for the government to use taxes to provide financial support for those unable to support themselves. Also when did we have "Wall Street buddies"? What Bizarroworld are you living in? Because Hillary Clinton (hardly a left winger herself) made a few speeches to a bank or two Wall Street is left wing now?
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Re: Occam's Razor
I'm asking for evidence on your claim "he indoctrinated them according to a particular ideological playbook."
Poverty is a tricky issue. Ask the government of literally any red state except for Texas. Their economies are all garbage and their state's packed full of poverty.
Using correlations between state level political choices and poverty to try to make arguments about causation is utterly silly. Try again.
Oh geez, this is embarrassing for you https://www.factcheck.org/2017... [factcheck.org] . We gained a lot of jobs under him. Maybe you are the type to just make things up.
No, you're simply the type not to understand statistics. Let's take the first number: "The economy gained a net 11.6 million jobs." Sounds good, doesn't it? Except that the US population grew by about 20 million people during Obama's presidency, so this is below what was needed simply to keep the labor participation rate the same.
Yup, it's really looking like you're the type to make shit up. Medicare costs us less than $11,000 per user ( https://www.kff.org/medicare/s... [kff.org] , https://www.healthaffairs.org/... [healthaffairs.org] ) and currently covers about 15% of the population ( https://assets.aarp.org/rgcent... [aarp.org] ). Per American that comes out to 1,600 per person so no it does not cost more per American than any socialized system. In fact, it's not even close.
The Medicare budget is $1055 billion and the Medicaid budget is $579 billion. There are 326 million Americans. When you do the math, you get $5000/American.
Well I don't think being "fully privatized" would get us healthcare coverage for our poorest as we're already pretty privatized and can't do that but we can certainly agree Obama Care isn't great.
You're right: I was imprecise. We have a fully privatized system, albeit a corrupt one. What I meant was that our two realistic alternatives are a fully nationalized system (like the UK and France) or a minimally regulated free market system. And a minimally regulated free market system would lower costs so much that even the poorest Americans could afford it.
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Re: Occam's Razor
"I'm not sure what exactly you are asking.
I'm asking for evidence on your claim "he indoctrinated them according to a particular ideological playbook.". Clearly you're an intelligent person who wouldn't just make shit up because your ideology says you should not like something, right?
"Are you asking for evidence of "he's one in a long line of people who use the poor and the desperate to lift themselves into political office with no ability or intention to actually help them"?"
Poverty is a tricky issue. Ask the government of literally any red state except for Texas. Their economies are all garbage and their state's packed full of poverty. Meanwhile encouraging people to participate in our Democratic process is about as American as you can get and doing so with the people least likely to participate even more so.
"We're not debating whose fault it was, we're simply debating whether the statement that Obama created a lot of jobs is a reasonable assessment of his presidency, and it is not."
Oh geez, this is embarrassing for you https://www.factcheck.org/2017... . We gained a lot of jobs under him. Maybe you are the type to just make things up.
"We already have a massive system of socialized medicine, called Medicare/Medicaid. It already spends more per American (again not per patient but per American) than many European systems of socialized medicine. So the problem is not that we lack sufficient funding for socialized medicine, the problem is that the system of socialized medicine we have is horrendously inefficient and overpriced. And Obama did nothing, zero, zip to fix that."
Yup, it's really looking like you're the type to make shit up. Medicare costs us less than $11,000 per user ( https://www.kff.org/medicare/s... , https://www.healthaffairs.org/... ) and currently covers about 15% of the population ( https://assets.aarp.org/rgcent... ). Per American that comes out to 1,600 per person so no it does not cost more per American than any socialized system. In fact, it's not even close.
Even if we ignore your ridiculous claim of per American and look at per user it's actually pretty impressive how low that $11,000 is given that by design medicare exclusively serves our highest cost demographics.
"There clearly is. And there are three ways in which Obama could have addressed that problem: he could have fully privatized our system, he could have imposed a mixed system with strict cost controls, or he could have implemented a nationalized public system like the UK and France. All three of these can be made to work cost-effectively, given the right regulations. Obama did none of those."
Well I don't think being "fully privatized" would get us healthcare coverage for our poorest as we're already pretty privatized and can't do that but we can certainly agree Obama Care isn't great.
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Re:Don't be mistaken
How is a government bureaucrat paying a doctor less of a middleman than an insurance company bureaucrat paying a doctor?
No marketing, no execs with golden parachutes and private jets, no department devoted to denying coverage, no B.S. wrangling between insurance companies to decide who has to pay, no duplication of admin/HR/etc between competing insurance companies, no profit required to send to screaming shareholders... I could go on and on, but instead I'll just post some facts. In the U.S., socialized healthcare costs are already far lower, and growing more slowly, than private health insurance: https://www.healthaffairs.org/...
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Re:Government should just drop the product.
Statistical studies have found no correlation between R&D costs and drug prices. http://healthaffairs.org/blog/... There are a few other studies floating around that have clearer results but I'm busy today and didn't find them in my first 30 seconds of searching. Long story short the idea R&D costs are a driving factor in drug costs was a valid theory. It, however, has been proven wrong.
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Speaking of Canadian Trash
as a Canadian I agree! We don't Americans coming up here and ruining this great nation with their bizarre, trashy world views.
Counterpoint: Yesterday when walking along a trail in the U.S. I had to pick up a Tim Hortons bag and various boxes inside. Americans may have some "trashy views" but you Canadians are spreading LITERAL trash in America. Yet again Americans are left to clean up messes other countries make.
So I'm more than happy to support that wall into Canada, I'm not so sure all the Canadians that cross over to shop in the U.S. from Canada or to get real health care would be all that happy.
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Re:Madness
Yeah, you're full of shit.
Example number one.
Example number two.
I could pull up more, but to be honest you're just an intellectually dishonest shithead.
In addition, after serving in the military with contractors doing our job for five times the price I think I have a bit of perspective that you don't.
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Re:Thanks Obama!
While I agree with everything you just said, both of your proposed solutions are the exact opposite of the Republican platform on healthcare reform. That isn't hyperbole, the core of their plan is to increase reliance on private insurance and push more responsibility to the states.
Indeed, the Republican platform is to funnel even more money to private insurance. In fact, Paul Ryan's Medicare "reform" plan is to push all Medicare recipients onto private plans (but still paid for by the government, via vouchers) so that the private companies can make even more profits. According to this article, Medicare administrative costs are about 2% of operating expenditures while private insurance runs about 17%. This doesn't include marketing or profits for the private insurance, with those items the overhead is 20-25%. So up to a quarter if the money paid for insurance to these companies doesn't even go to actual care and Ryan wants to push our our seniors into that environment, while the rest of us pay for it (or don't, just run up the debt some more). Ryan's plan would be a huge government handout to the insurance companies, even larger than Obamacare, which was a MASSIVE insurance company handout. As this article observes, the Republican base are the exact people who would benefit most from lower-cost healthcare but for some reason in every election they manage to vote against their own self-interest. It's just mind-boggling, it seems like they would be willing to set their own world on fire rather than see a single person get something from the government that they didn't "deserve".
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Re: New Trump fan here!
Probably the one Mike Pence implemented in Indiana. And, as a recently unemployed guy with no insurance living in a state that didn't expand Medicaid, it sure sounds pretty fucking good to me. Having to pay a few dollars co-pay is not much of a downside when it would mean everyone (including me) could finally have health insurance. A $3 co-pay on a doctor visit vs. having to pay full price? Sign me up, Mr. President!
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Go audit yourself
Are we supposed to trust Tesla's own results of testing Tesla's product? Seriously? 98% is entirely too low in such circumstances, Saddam Hussein got 100%...
Medicare administrators too, for example, would've liked us to think, the program loses only about 1% of its budget to "fraud, waste, and abuse" (better to claim the government being more efficient than KKKorporations) while the independent audits show figures of at least 6% (or even 10%).
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Re:Yeah it's called being self-insured
Employees should be paid with money and only money.
And they were — until the US government imposed limits on salaries during the Second World War. Employers wanting to attract employees invented the "benefits packages" of various kind, that circumvented the government-imposed maximum wage limits.
As the consumers of and payers for services became different entities, the prices started to rise. Attempts at finding a government-based solutions to the government-created problem further exacerbated it, as always happens. And continue to.
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Re:ENOUGH with the politics!
Aaron Carroll, who now writes a column for the New York Times, has written about this.
http://www.aarp.org/politics-s...
5 Myths About Canada’s Health Care System
The truth may surprise you about international health care
by: Aaron E. Carroll, M.D., M.S.
AARP
April 16, 2012
Myth #1: Canadians are flocking to the United States to get medical care.
Study in Health Affairs, Phantoms In The Snow: Canadians’ Use Of Health Care Services In The United States. Ambulatory care facilities near the border saw 65yo, and 1,500 were >85. In the U.S., most hip replacements are paid by Medicare, a single-payer system.
Myth #4: Canada has long wait times because it has a single-payer system.
Longer wait times are the result of a decision to save money and be fiscally conservative.
Myth #5: Canada rations health care; the United States doesn’t.
The U.S. rations by ability to pay. Adults in the U.S. are more likely to go without care because of costs. 42% were not confident they could afford care if they were seriously ill.http://content.healthaffairs.o...
Phantoms In The Snow: Canadians’ Use Of Health Care Services In The United States
Steven J. Katz, et al.
doi: 10.1377/hlthaff.21.3.19 Health Aff May 2002 vol. 21 no. 3 19-31
Abstract. To examine the extent to which Canadian residents seek medical care across the border, we collected data about Canadians’ use of services from ambulatory care facilities and hospitals located in Michigan, New York State, and Washington State during 1994–1998. We also collected information from several Canadian sources, including the 1996 National Population Health Survey, the provincial Ministries of Health, and the Canadian Life and Health Insurance Association. Results from these sources do not support the widespread perception that Canadian residents seek care extensively in the United States. Indeed, the numbers found are so small as to be barely detectible relative to the use of care by Canadians at home. -
Re:Common sense prevails! (Only Partially!)
No. The anti-vax movement has been largely driven by greed, stupidity, and the parents need to "blame" someone.
No. The anti-vax movement has been entirely driven by unethical pharmaceutical behemoths killing/maiming thousands of children in third world countries, unloading worthless crap on ignorant asshats and raking in massive unearned profits on the misery of millions.
Glaxo Smith Kline was fined a paltry amount after performing unethical "experiments" on children and killing fourteen of them. Would you trust these jackasses to inject your kids? Hell, their own scientists had to be bribed to cover that shit up. Faked vaccine data lessens confidence in Merck products.
Merck has lied for years about the efficacy of their vaccines. Why would anybody trust them?
Other countries ban defective vaccines, it's not rocket science to shun poisonous garbage that makes your populace sick and decreases productivity for potentially years. MMR vaccine, lookin' at you.
And that's not even counting poor vaccine quality control, a persistent issue for these massive corporations. In that one case Merck got caught before they could offload those 1,000,000 deadly doses on some unfortunates in Africa and collect tax credits for their philanthropy from the IRS.
FFS even the Nigerians are skeptical by now. Looking at the preponderance of shady practices, outright lies and poor quality of your average vaccine peddler it's no wonder the anti-vax movement is gaining momentum. But don't take my word for anything, go get your annual flu vaccine and risk paralysis or worse, and forget about that "immune system" crap the hippies are trying to foist on everybody. Nutrition isn't that important and you have a basement to live in and keyboard crumbs to make. -
Re:The real crime here
Advancements in medicine (drugs) have reduced crime (they have almost eliminated the need for insane asylums)
Tell that to all the homeless schizophrenics on the street due to deinstitutionalization. We have not eliminated the need for forced institutionalization we have limited it some but mental health is a seriously neglected part of american society. Here's a less sensational article if you don't like the other one.
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Re:Single Payer
I realize there is nothing I can say which will make you pull your head out of your ideological corner, but you have gone from claiming single payer systems have no competition to maybe they do but they are worthless and expensive to maybe they're ok, but you don't want to pay for mine. So let's take the next logical step and have medicare for all. That way we will all be paying and all be getting the benefit. It should have the added advantage of slowing the rate of growth of medical costs, since the US is the only OECD country with does not have some kind of government provided health care for all residents and it costs us 50% more than the next most expensive country for generally lower quality healthcare. Here are some links for you to consider.
http://www.pbs.org/newshour/ru...
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Re:ObamaCare is a Horrific Debacle
Do you have an non-anecdotal evidence for your theory?
http://content.healthaffairs.o... seems to contradict your claim with actual data - though it's data is getting old, so maybe you have something newer rather than just making up theories in your head with no actual evidence for them?
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Re:Alternative headline: "Let kids play, and they
There are no lawsuits for personal injury in New Zealand.
Yes -- you're right. I forgot about that quirk in tort law there.
One of the benefits of a really good nationalized health care system.
Umm, not really. Have a look here for some historical perspective:
New Zealand's compensation system arose not in response to concerns about medical malpractice but through farsighted workers' compensation reforms. A Royal Commission, established in 1967, concluded that accident victims needed a secure source of financial support when deprived of their capacity to work.
Until 1992, when medical terminology in the act was clarified so it was clear that medical accidents were covered, claims for medical injuries were very few. (The article I linked notes that, historically, only 0.05% of claims for personal injury were related to health care on average.)
So, no -- this "benefit" came out of a desire to provide compensation to people who were the victims of accidents in general, and particularly out of compensation for workers. (I have nothing against nationalized health care, by the way -- and I think it can be a very good idea. But it is not the reason why personal injury torts are prohibited.)
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Re:Of course it is here to stay
The rap is that "in 1981 the Reagan administration orchestrated the repeal of the Mental Health Systems Act, consolidated the categorical mental health programs into a block grant, and cut spending on those programs about 25 percent". Of course it was part of an effort to rescue the economy from the dump worse than at any time since the Great Depression. The merits on both sides can certainly be argued.
But one thing that CANNOT be argued is that "the Reagan administration did it". Note the weasel word "orchestrated", in which the writer attempts to sidestep the absurdity of the claim. No President and no "administration" can repeal anything. Repeal of a federal law takes an agreement between a majority of the House, a majority of the Senate, and the President.
Maybe the people of the USA, through their elected representatives, did the "orchestrating".
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Re:And this is only sign-up
Imagine the system that needs to be created to administer every aspect of health care for all 350 million Americans. Tracking patient visits, expenses, coverages, drugs, etc. etc. along with all the financial distributions to thousands of hospitals, doctors, clinics, pharmacies, etc.
You mean like Medicare and Medicaid and their exceptionally small overhead?
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Re:really?
Why do Canadians often come to the States for treatment?
The number of Canadians who receive any health care in the United States for care is vanishingly small. In a country of 30 million people, it is relatively easy to find a few who do so, and who can offer a sound bite for a newscast or an anecdote for a blogger. The fraction of Canadians who receive medical care in U.S. hospitals and clinics appears to be around the 0.5% mark.--of whom roughly 4 out of 5 do so because they happened to fall ill while visiting the United States, and not because they travelled there to receive medical services.
For certain urgent care services, communities close to the Canada-U.S. border can and do make arrangements to share facilities. (If someone has an urgent need for specialized cardiac or neurological care, you want to go to the nearest major hospital, not just the nearest one on your side of the border. Patients flow in both directions under these agreements; there are regular transfers from northern Washington state to Vancouver hospitals.)
Why does the Elderly death rate in Britain start climbing, late in the summer, and start going down again after the new Fiscal Year starts ??
Because high temperatures combined with substantial swings in temperature - typical late-summer weather, and likely exacerbated by climate change - are physically stressful. The same pattern is observed in the United States.
For that matter, why are so many doctors from Single-payer countries practicing in the States, instead ???
I don't have all the data at my fingertips, but in every year since 2004, there has been a small net migration of doctors out of the United States and in to Canada. Further, doctors practicing in Canada (and in the UK) report being significantly more satisfied in their jobs that their colleagues in the United States.
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Re:Corporate executives are smart.
Yes, they wanted a single-payer system. But they want the Government to be the single payer so the bureaucratic army of paper-pushing micro-managers can verify everyone is being treated equitably. Which costs more, not less, so less money is left for patient care. Lose/Lose
Everyone wants their micro-managing middle persons taking peoples money to grind the red tape wheel. We just need to ditch the mandatory micro-managing middle persons.
You need to check your facts, Gary. I know. I know. Facts are *soooo* inconvenient.
So. Are you just dumb and gullible, or are you an evil fuckhead?
Posting AC to preserve my mods on this thread.
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Re:Yeah...
Well that's total BS. As somebody who works in the medical insurance biz, I can assure you that it's known to everybody in the entire industry that Medicare costs less per patient with similar diseases, etc. than any other private insurance. http://healthaffairs.org/blog/post_images/2011_08_05_1.jpg
Couldn't be otherwise; Medicare has the biggest number of patients, so can drive the hardest bargain with any provider. Thus Medicare has the lowest contracted rates with doctors and hospitals. That's the big thing; any savings from not having to find 3% profit or not marketing etc is just icing on the cake.Why do all the right wingers solemnly tell us that government bureaucracy makes Medicare more expensive, less responsive, whatever, than private insurance? Do they not know that there is no Medicare bureaucracy sitting in Washington or somewhere adjudicating claims, paying or rejecting them, etc., but that Medicare contracts with private insurers to do the job? The Medicare bureaucracy is literally the exact same bureaucracy as the Aetna bureaucracy, or the Cigna bureaucracy, or the Wellpoint bureaucracy, or whoever is handling it in your state..
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Re:The spending is very concentrated
you cannot tell who will need expensive health care
We obviously can't predict accidents, but we do know that, for the average person, the bulk of their health care costs will be in old age, and those costs will increase as they get closer to the point of death. 27 percent of Medicare spending covers care for people in the very final year of life (source). If we were more accepting of death, then we would probably not bother to squander so much money when the end comes. From a financial perspective, it would make more sense to develop a matrix of cost/benefit, and to offer patients either the treatment or some fraction of the equivalent cash to give to their families. Or to develop a statistical model, and only provide baseline medical service when the probability of death in the next 12 months exceeds 95% or so. Rational, but perhaps not politically/socially viable.
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Re:But it's a good idea...
Parents who want to drink, smoke, or shoot-up the money their kids need for food will do so whether the kids get free food or not. I've seen it, but by all means, show these kids that the world is a callous place and they should look only at cost and benefit (for themselves). Most crime has excellent cost benefit ratios. There is also a substantial public interest in people working within the system. Starving people or people who never have a hope of getting ahead do very dangerous things, and they don't look to the future (or avoid pregnancies).
From a budget perspective, these programs appear to account for 14% of the budget, money well spent IMHO. There are some child health care costs rolled up in the 21% on that page for medicaid, but 25% of the 21% is spent in the last year of life. So the spending on older Americans who may or may not need a social program dwarfs the spending on children.
Children are a national treasure. -
Re:WOAH WOAH WOAH
This is so ridiculous I am undoing moderation to reply.
Congratulation. You wasted your mod points so you could expose your own ignorance.
You are also forgetting the burden illegal immigrants put on our welfare system. Since they often work for low wages and live below the poverty line they qualify for all sorts of benefits. In Wisconsin they get excellent health care (better than my current employment benefits and they pay nothing for it), housing assistance, heating assistance, food stamps, etc... all on the American taxpayer's dime.
Bullshit. With the exception of maybe the children of immigrants, illegal immigrants genreally do not qualify for any type of welfare, food stamps, or housing assistance. Regarding health care, studies have shown that illegal immigrants place a lower burden on our health care system than citizens of the same socioeconomic class. Here is a second study which came to the same conclusion. Here is a third. A fourth.
Interestingly it seems that these programs were tailored for illegal immigrants as you do not need a social security number to qualify--meaning you don't have to be paying taxes to get the benefits.
I've never heard of a state giving illegals welfare-type benefits. I'd love a link to these programs in Wisconsin you speak of. Got one?
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Re:Correction
Sorry, but cost-of-living by city is not the same as that of a country as a whole. Tokyo comes quite high, the whole of Japan not as much. Facts you know, which vary a bit due to exchange rates.
And the BS on true costs? I'm talking about per capita cost for the whole thing based on OECD studies. A person doesn't pay anything himself it's all aggregated and newer figures than those in the link show the US is only exaggerating the gap.
So no, I won't find that the total cost of health care is more in socialized systems it's the opposite. It's the gigantic white elephant in the room that americans just refuse to see despite the numerous studies. And it's not 'my' cost analysis...
BTW, the state of civil liberties in a country is not defined by the most liberal of people in a country, rather it is defined by who you allow into power. (note; using the real definition of liberal not the us version)
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Re:$3k/worker
The big reason physicians are less productive with EMR systems is that they need to learn how to use a computer properly. This means using password-protected screen savers instead of fully logging out, and spending $35 a month on a network connection faster than dial-up. It means taking some typing lessons, and getting used to the feeling of a keyboard rather than a pen.
I also note that you very carefully mention only private practice, rather than doctors in any large organization. That reminds me an awful lot of the "get off my lawn" mentality held by most private practices. They have THEIR way, and God forbid anybody try to recommend changing it. Never mind that it would decrease errors, which would make malpractice insurance cheaper, which would bring more profit, but I digress.
Regarding EMR and insurance, your point is moot. Insurance claims are ALREADY required to be filed electronically as part of HIPAA. Now the records will just be stored in a computer in the hospital, reducing the error rate introduced by transcriptionists. If there's going to be any change, it's more likely to be positive. The insurance company can, in one request, see that tests were run that indicated a specific treatment, rather than ask ten times for the results of each test.
Since you seem to appreciate studies, here's a few nice ones (found by searching on Google for "study emr effectiveness":
- The Effect of Organizational Factors on the Effectiveness of EMR System Implementation"For practitioners considering or about to begin an EMR system implementation, these results highlight the importance of considering organizational factors before, during and after EMR system implementation"... In other words, if it doesn't help, you're probably doing it wrong.
- Can Electronic Medical Record Systems Transform Health Care? - A rather comprehensive examination of costs and savings. Here's a spoiler: EMR costs far less than non-EMR.
- EMR Reminder Improves Osteoporosis Management: Discussion - "EMR reminder intervention resulted in 51.5% of patients receiving a BMD measurement or an osteoporosis medication, compared with 5.9% in usual care."
Looking at those listed credentials, it seems the research is being funded by drug companies. I know from personal experience that drug companies love EMR for the same reason I do: hospitals using EMR are easier to work with for exchanging medical data. Again, the insurance companies don't care, because they've enjoyed electronic records since 2003.
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Re:I don't understand
They were pulling numbers out of their asses. The Harvard study says it's a lot worse. http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.63/DC1
Among those whose illnesses led to bankruptcy, out-of-pocket costs averaged $11,854 since the start of illness; 75.7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fall prey to financial catastrophe when sick.
and
Debtors with private insurance at the onset of their illnesses had even higher out-of-pocket costs than those with no insurance (Exhibit 5). This paradox is explained by the very high costs--$18,005--incurred by patients who initially had private insurance but lost i
Just look at the "out-of-pocket" expenses - and keep in mind that this doesn't include having to continue to pay insurance premiums while losing revenue because you're ill
,,, url:http://content.healthaffairs.org/content/vol0/issue2005/images/data/hlthaff.w5.63/DC1/Himmelstein_Ex5.gif? -
Re:Healthcare
something will make things worse
If you have evidence showing things will get "worse" that isn't based on anecdotes and an irrational fear of "socialism", then by all means present it. Unfortunately for you, there is plenty of evidence showing things will in fact get significantly better if we switched to a publicly run system. Paper after paper has been written showing real gains in efficiency that would save the average American thousands of dollars a year. But hey. don't let reality and facts get in the way of your gut beliefs.
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You're already being taxed for it.
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Re:The more likely scenario
*Can't get behind the paywall to determine if benzos were considered to be antipsychotics
It's not really a paywall, since it doesn't actually ask you to pay anything (without getting into the discussion about whether "viewing ads" is another form of payment, which I believe it is). You do have to register, but that's it.
Here's a link to the study that the reporter used. linky
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Re:The same for drug industry
Source please? I think you would be astonished by the cost of developing a new drug. Also bear in mind that drugs are only marketed strongly in the US. Most countries do not allow prescription drugs to be advertised to consumers.
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That's a myth.
Yet people still come from around the world and pop across the border from your beloved Canada to seek treatment in the US, because it's the best in the world.
That's a myth, actually. But quite ironically, a lot of people in the USA seek health care treatment in Mexico.
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Re:Great quote...
Yes, but the reason that health care costs are so high in America is that we have the best quality of health care in the world.
America may have some of the best care in the world for those that can afford it. But the median level of care is most certainly not the best in the world, and the overall level of care we receive per dollar spent is event worse.
Rather than continuing this thread's trend of anecdotes and ideology, here's a study which describes how and why the US's health care system is different than other countries.
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Re:The assumption here
Checking out my Googlefoo, I came across this article. This is quite a bit lower than my seat of the pants guess which was about 5-10% but the article seems to discuss only direct costs and ignores the real issue of "defensive medicine" where a doctor orders a test or procedure "just in case".
I doubt if anybody can get a good handle on that number. The bottom line, however, is that malpractice costs are actually not a huge part of the spiraling medical cost problem in the US. -
Market forces? You're both right and wrong...Monopoly power allows sellers to raise prices above those they would obtain in perfectly competitive markets. In the jargon of economics, they are thus able to earn "rents," defined as the excess of the prices actually received by sellers above the minimum prices the sellers would have to be paid to sell into the market. Countries differ in the degree to which they try to whittle away at the rent earned on the supply side through the creation of market power on the buy (monopsony) side of the market. A single-payer system would be called a "pure monopsony." - Health Affairs, 22, no. 3 (2003): 89-105
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Re:Maybe fix your health care "system" first?The grandparent was complaining that "medical procedures are insanely expensive and the equipment and medicine costs are through the roof" before making the laughable statement that "it's not like medicine got any better in the last 30 years".
From It's The Prices, Stupid: Why The United States Is So Different From Other Countries:
Monopoly power allows sellers to raise prices above those they would obtain in perfectly competitive markets. In the jargon of economics, they are thus able to earn "rents," defined as the excess of the prices actually received by sellers above the minimum prices the sellers would have to be paid to sell into the market. Countries differ in the degree to which they try to whittle away at the rent earned on the supply side through the creation of market power on the buy (monopsony) side of the market. A single-payer system would be called a "pure monopsony."
In the U.S. health system, for example, money flows from households to the providers of health care through a vast network of relatively uncoordinated pipes and capillaries of various sizes. Although the huge federal Medicare program and the federal-state Medicaid programs do possess some monopsonistic purchasing power, and large private insurers may enjoy some degree of monopsony power as well in some localities, the highly fragmented buy side of the U.S. health system is relatively weak by international standards. It is one factor, among others, that could explain the relatively high prices paid for health care and for health professionals in the United States.
In comparison, the government-controlled health systems of Canada, Europe, and Japan allocate considerably more market power to the buy side. In each of the Canadian provinces, for example, the health insurance plans operated by the provincial governments constitute pure monopsonies: They purchase (pay for) all of the health services that are covered by the provincial health plan and used by the province's residents.
Of course, Medicare is also forbidden from using its buying power to lower costs, anyway. -
Re:Too lazy...
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Re:Let me guess...
Another myth. Malpractice suits account for 0.46% of our total healthcare expenditures. An interesting observation is that Canada, for example, actually pays out more to plaintiffs than US courts do.
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Actually we'd be paying 0.46% less.
0.46% is litigation
The cost of defending U.S. malpractice claims is estimated at $6.5 billion in 2001, only 0.46 percent of total health spending. The two most important reasons for higher U.S. spending appear to be higher incomes and higher medical care prices.
The medical insurance companies are making lots and lots of money, and that's not because they are giving services for the dollars they are taking in. -
Re:The healthcare market has only one impediment.
Given that the medical expense is now the leading cause of declaring personal bankruptcy in this country, and of those doing so are mostly middle class, I suggest you have no idea what you're talking about. Of those declaring medical bankruptcy in 2001, a little more than 75% did in fact have insurance coverage at the onset of their illness.
So it's not people choosing to be poor and/or choosing not to have insurance. Thanks for playing. -
Re:The healthcare market has only one impediment.
Given that the medical expense is now the leading cause of declaring personal bankruptcy in this country, and of those doing so are mostly middle class, I suggest you have no idea what you're talking about. Of those declaring medical bankruptcy in 2001, a little more than 75% did in fact have insurance coverage at the onset of their illness.
So it's not people choosing to be poor and/or choosing not to have insurance. Thanks for playing. -
Re:That's alot of power / control
This is all off-topic, but I think you're conflating socialism with communism. This is mere semantics, so let's move on.
On health care, the UK's NHS is not a sterling example of socialized medicine, but even that system produces better outcomes (longer life expectancy, lower infant mortality) for less money. Per-capita health care spending in the US is twice that of the UK. In fact, the US government spends more per patient than any other country in the world besides Switzerland without even providing universal coverage.
http://content.healthaffairs.org/cgi/content/abstr act/21/4/88?ijkey=04dd1e69c6cd96f69bfbc7aa987d8aad 057415d2&keytype2=tf_ipsecsha
I'll see your anecdotal evidence and raise you facts.
Respectfully,
-Isaac -
Re:Not just true for humans
"The OP has a choice about which coverage option to choose, and can change if it's not the best option given individual circumstances. You don't and can't."
Incorrect. Canadians are free to purchase additional coverage over and above the provincial plans at their own cost or with costs shared by employers. The provincial plan is a *baseline*, not a *ceiling*.
"Things don't come for free. It's all about how you choose to pay for it. Personally, I'd much rather have the choice in my own hands, rather than in the hands of a politician who can't possibly know what's best for me as an individual, and has only weak standards of efficiency to live up to."
You clearly don't know about how private insurance works, if you think "efficiency" has anything to do with it. Private insurers eat up to 30% (industry average of between 10% and 15%) of all premiums in "overhead" costs (salaries, buildings, processing, etc.), compared to less than 5% for public insurers (See http://content.nejm.org/cgi/content/abstract/349/8 /768 and http://content.healthaffairs.org/cgi/content/full/ 24/6/1629 and http://www.citizen.org/pressroom/release.cfm?ID=16 23 for starting sources and you can continue your research from there).
What's far more amusing in your stance, however, is your willingness to trust profit-motive-driven corporations with knowing what's best for you as an individual (you don't pick your health plan--your employer does, and even then they can only pick what plans are *offered* by the insurance companies) which have no accountability to you whatsoever, rather than trust someone who is ultimately accountable to the citizenry such as elected provincial officials and the offices they oversee. -
Re:Probably not.
I doubt it. I bet there are more bankruptcies as a result of credit card overextension, or poorly managed home loans, than as a result of medical expenses.
A recent study that made some ripples in the media indeed found that half of all bankruptcies were due to medical bills. Most frighteningly, they found that 75% of families forced to declare bankrupcty for medical bills had health insurance. -
Re:Concern for human rights is not a team sportHa ha. Come on, if you're going to troll, at least put some thought into it. Be a bit original. You put the whole Troll Tuesday concept to shame.
One country is making progress, but not as fast as some would like. The other is turning back the clock. Pointing out that a story of the US making such a statement would be believable in NO way condones wrongs by either side.
Besides, I think BadAnalogyGuy has prior art on your posting style
:-)Now, if I had wanted to do some serious trolling, I would have pointed out that most western countries, with the notable exception of the US, consider state-provided basic health care a universal human right. Funny how China shares this value, but in the US, "no money, no candy-striper."
Medical problems are the #1 cause of personal bankruptcy in the US, when both direct http://content.healthaffairs.org/cgi/content/full/ hlthaff.w5.63/DC1 and indirect effects are factored in. And its not people who are without coverage - " 75.7 percent had insurance at the onset of illness". - think of that - more than 3/4 of those who went bankrupt because of medical bills had insurance.
What a scam.
Talk about preying on the sick and the weak - look at your local politician, and how much they're beholden to the HMOs rather than to the voters.
So, does the person who has to go bankrupt because of medical bills get to enjoy any of the benefits of capitalism, like accumulation of private property and wealth? Nope - the trustee gets to hand over everything to the creditors, with a few basic exemptions, and even this isn't enough to keep many people off the streets or bunking at a relatives.
Some simple math - " 1.9-2.2 million Americans (filers plus dependents) experienced medical bankruptcy". Multiply this by an average life expectancy of 72 years, and you've got 144 million people who will affected by a medical bankruptcy over the course of their lifetime.
That's half your population who would be better off under a "communist, socialist" system that other countries, such as that "notorious socialist communist pinko terr'rist havens" (such as Canada) have. Talk about a class structure with haves and have-nots!
Food for thought: http://www.bankruptcycanada.com/blog/canadian-and- us-bankruptcy-rates/
Bankruptcy Rates in the Canada and the US - The huge disparity is because of the health care system.
The US bankruptcy rate (6.9 per thousand) for the year 2004 is more than twice as high as the Canadian bankruptcy rate (2.6 per thousand). The main reason for the huge disparity in bankruptcy rates in Canada and the US is because of the different health care systems in the two countries.
Canada has universal health care for all citizens paid for out of taxes. The US system is based on private enterprise mainly provided by insurance companies.
A Harvard Study reported that half of US bankruptcies were caused by medical Bills (MSNBC) & (ABC News). The study was published online in February of 2005 by Health Affairs. The Harvard study concluded that illness and medical bills caused half (50.4 percent) of the 1,458,000 personal bankruptcies in 2001. The study estimates that medical bankruptcies affect about 2 million Americans annually -- counting debtors and their dependents, including about 700,000 children.
Most of the medical bankruptcy filers were middle class; 56 percent owned a home and the same number had attended college. In many cases, illness forced breadwinners to take time off from work -- losing income and job-based health insurance precisely when families needed it most. Families in bankruptcy suffered many privations -- 30 percent had a utility cut off and 61 percent went without needed medi
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Not at all true.
Did you know that in the US in 2006, more children will grow up in homes that have declared bankruptcy than will grow up with divorced parents?
Did you also know that as of 2004, over 50% of all bankruptcies in the US are directly related to a major medical illness somewhere in the family?
50% Medical Bankruptcy article (2005)
Article stating number of bankruptcies in 1999 (~ 500,000 families)
Article stating number of bankruptcies in 2001 (~ 1.5 million families) -
You know less than you think you do
Try reading this, or even better the Actual Study if you want to have the opinions the mass media prefer to feed you shattered. In fact for a great education just click on the study link and read all of the articles that referred to it, all linked on that same page.
I don't know about you, but counting gambling issues or death in the family as a "medical problem" does not seem to be playing straight. That was a study that already had an obective in mind before the writing began.
I know you will be reluctant to believe the real truth, but at least I can help countless others pull the wool away. -
Re:Better hope you don't fall on hard times
We are going to see the credit card companies squeezing the life out of people who need to declare bankruptcy because of medical emergencies. 75% of bankruptcies are caused by medical illnesses.
The Democrats tried pushing a concession that would limit the interest rate on a credit card to 30%. The Republican's rejected the measure. It is scary to think what credit card companies are going to charge people who fall victims to debt. -
Re:The same thing everybody else should do
most I know come to America for it since theirs is so bad.
Bzzt. Wrong.
http://www.healthaffairs.org/freecontent/v21n3/s6. htm