Does anyone else think this is a little strange? (loft, home)

[erieguy]

What about Bidencare?

[svband76]

Originally Posted by erieguy

What about Bidencare?

Memory Care for all?

[eschaton]

Originally Posted by Charley Barker

Wow. Thesis grade analysis here. Well done, you!

It should be noted that there are different service delivery models, NOT based on the "eat what you kill" concept (meaning maximize profit on the sickest patients with the greatest potential for healthcare interventions). The Cleveland Clinic is an example of a comprehensive system that is guided by outcomes, not rewarding providers with the highest utilization. From the Forbes magazine article below: "Cleveland Clinic has a salaried physician model. So we do not incentivize our providers on anything other than the quality and experience of care that they provide.”

https://www.forbes.com/sites/robertr...h=6ea8da071dc5

Yes, doctors should be workers directly employed by hospitals, not independent contractors who get a cut of everything for being an "attending physician." The outright bribes that are provided to physicians by drug companies in particular (providing "free samples" they write off to Medicare, providing all-expense paid medical conferences which are just vacations, etc.) are in particular odious. However, actually criticizing doctors, rather than medical insurers, in the U.S. is a third rail, even though providers are the real problem in our system, and insurance companies are more a symptom than anything.

Originally Posted by villageidiot1

You mention that there are "certain areas where the U.S. over-utilizes healthcare," but "overall we actually use less healthcare than other developed nations." Yet we spend much more than other countries on healthcare. So obviously there are potential areas for major cost savings. What am I missing?

The U.S. has much higher per-unit costs for everything. Higher costs for drugs. Higher costs for medical devices. Higher costs for hospital visits, higher costs for procedures.

Here's hip replacements:



Here's a drug cost:



Nightly hospital stays:



Angioplasty and bypass:



Everything is much, much more expensive in the U.S. than elsewhere in the world. As a result, even though we go to the doctor less, and stay in the hospital less, we end up spending about twice as much on healthcare.

[villageidiot1]

Originally Posted by eschaton

The U.S. has much higher per-unit costs for everything. Higher costs for drugs. Higher costs for medical devices. Higher costs for hospital visits, higher costs for procedures.

Here's hip replacements:



Here's a drug cost:



Nightly hospital stays:



Angioplasty and bypass:



Everything is much, much more expensive in the U.S. than elsewhere in the world. As a result, even though we go to the doctor less, and stay in the hospital less, we end up spending about twice as much on healthcare.

You know you open up a can of worms when you mention hospital costs? Are we comparing hospital charges vs. actual expenses when we compare the U.S. to other countries. If we compare the cost of manufacturing steel or a car in the U.S. to the cost of manufacturing those items in South Korea or South Africa, we know we are talking about real costs. I'm never sure with hospital costs to do a procedure like a hip replacement. Are you saying there is little we can do about high costs for healthcare in the U.S.?

[eschaton]

Originally Posted by villageidiot1

Are you saying there is little we can do about high costs for healthcare in the U.S.?

Absolutely not. But healthcare costs cannot be left to the "free market."

Essentially, there are two solutions to healthcare costs which the rest of the world has converged upon:

1. Government-run health insurance (socialized medicine, single payer, etc). The government uses monopoly power to set a price it's willing to pay with providers, and that is that.

2. A private system with price controls. This is what's used in Japan, Germany, France, etc.

Medical systems work just fine in the rest of the developed world with only around 50% of the same amount of dollars going in, so it's clear we don't need to have all this money sloshing around in the system to get decent health outcomes. A proper pruning would result in doctors (particularly specialists) making less money, and a lot of administrative type jobs being lost (i.e., people who work in doctor's offices to get paid by insurers, and people who work for insurance companies denying claims). But it could work just fine nonetheless.

[villageidiot1]

Originally Posted by eschaton

Absolutely not. But healthcare costs cannot be left to the "free market."

Essentially, there are two solutions to healthcare costs which the rest of the world has converged upon:

1. Government-run health insurance (socialized medicine, single payer, etc). The government uses monopoly power to set a price it's willing to pay with providers, and that is that.

2. A private system with price controls. This is what's used in Japan, Germany, France, etc.

Medical systems work just fine in the rest of the developed world with only around 50% of the same amount of dollars going in, so it's clear we don't need to have all this money sloshing around in the system to get decent health outcomes. A proper pruning would result in doctors (particularly specialists) making less money, and a lot of administrative type jobs being lost (i.e., people who work in doctor's offices to get paid by insurers, and people who work for insurance companies denying claims). But it could work just fine nonetheless.

Been a good discussion!

Which of your two solutions would control unnecessary/unproven procedures that add to the overall cost of healthcare. There have been studies regarding back surgery that shows surgeries are directly related to the number of neurosurgeons in an area. I almost had one of these done, but cancelled a few days before the surgery. Another one is a knee meniscectomy. I had one of these done and it did nothing. They are one of the most common surgeries for arthritis and torn meniscus. In fact, my insurance company and I have paid a lot of money in an unsuccessful attempt to fix my knees so that I can continue to play basketball well into my 60s.

Related to this is the question of how to motivate more doctors to go into primary care medicine and not specialize. Do we train enough doctors and are they in the right specialties?

[gg]

I don’t pay anything because I work and am a productive member of the civilized society. People that don’t contribute should have less. Lots of people in our country. The strong should lead and survive to promote greatness. The future depends on it.

[screechingweasel]

Originally Posted by Merge

Yes. You are definitely living in that sort of nightmare, where you apparently belong.

See, this is what I'm talking about. Just because I dissed your false gods, you automatically pigeonholed me as being some far right wingnut. You shouldn't have gone to college. Your mind was far too malleable. You would've made a much better solider. After you were finished with your military career, you could've bought an old farmhouse, settled down, gotten married, had a few kids, and raised some chickens. You could've used the old barn for all sorts of projects and endeavors. Maybe you could've taught yourself how to weld or something.

[erieguy]

Originally Posted by screechingweasel

See, this is what I'm talking about. Just because I dissed your false gods, you automatically pigeonholed me as being some far right wingnut. You shouldn't have gone to college. Your mind was far too malleable. You would've made a much better solider. After you were finished with your military career, you could've bought an old farmhouse, settled down, gotten married, had a few kids, and raised some chickens. You could've used the old barn for all sorts of projects and endeavors. Maybe you could've taught yourself how to weld or something.

I wouldn’t assume they went to college and aren’t raising chickens.

[Copanut]

Originally Posted by erieguy

I wouldn’t assume they went to college and aren’t raising chickens.

I just picked up a dozen eggs from my old college roommate. He lives on a farm. I'm not jaggin' yinz.