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Katiana - what is evidence-based care? Is this sort of like watching diabetics reduce their insulin intake as the disease is better managed? Is this watching cholesterol levels go down? Is this like case management on a larger scale?
Regarding pharma costs, I wish patents were granted for a shorter period of time, only enough to recover R&D costs for the product. The sooner the patent expires, the sooner the drug becomes generic, as well as the sooner competitors can produce the drug with the same ingredients. Competition will naturally reduce the price.
I would like malpractice insurance premiums reviewed/regulated in tandem with tort reform. It kills ob/gyns to fork out $130,000 a year in malpractice premiums. No wonder more are leaving the practice, and we can't afford for them to leave. Many ob's leave out the ob part and just practice gyn. Providers order a lot of procedures for fear of being sued for negligence.
I agree tort reform and malpractice regulation should go together. A Doctor should not be put out of his/her specialty due to malpractice premiums.
Michigan has passed tort reform regulations and physicians groups have stated malpractice rates are dropping. Every time I turn on the TV I have to hear Dr. Kovorkian's lawyer explaining how the "saviors of the people" trial lawyers, aren't able to help the defenseless anymore because of Michigan lawmakers. He's just so pseudo-earnest I want to puke whenever I see him.
I think , knowing a few twenty somethings myself, that if insurance were affordable and reasonable they would have NO PROBLEM purchasing it. The problem is, everyone wants to say that "oh they dont' buy it because they want to by new phones, new cars" nonsense like that..
THat is SO wrong.. there is no proof of that anywhere. Many 20 somethings fresh out of college need to pay off student loans.. need to save something for a rainy day, need to pay rent and so on and so forth. Many twenty somethings I have known (and I was a twenty something not too long ago!) are eating mac and cheese working on building their careers. Paying a large percentage of their paycheck is out of the question NOT because they want all these "toys"..but because they have other life expenses and college expenses to pay off.. AND YES.. CREDIT CARD BILLS NOT because they went crazy shopping.. but because while going to college the lived off their credit cards to make ends meet.
Again.. if premiums were reasonable they wouldnt have any problems purchasing them.. Heck if my premium didn't take up a whopping 16% (and again that's conservative considering that where I live I make MORE than the national middle wage income) of my income I wouldn't be complaining either.
the premiums for people in their twenties are reasonable, there are plans for $75/mo, as more people buy it the costs will come down and there are plans for people who truly can't afford it. They just don't want to buy insurance because they don't need it yet.
Hee Hee. I was waiting to hear from you, Bibit!!! Policies would have to be community based.
Assessment would have to be made as to what is already available w/in the State for provision of such things as well-care and preventive care (such as free vaccinations thru/ public health depts).
New protocols would have to be written. Things such as bariatric surgery - I seriously doubt it, except in morbidly obese and life-threatening. I think the current standard of 75 lbs overweight is laughable and ridiculous and I find it maddening that insurance companies cover bariatric surgery except for those w/ life threatening situations. However, I think bariatric surgery is heinous anyway . . .and the risk for morbidly obese is way too high to justify it in most cases. Now that is a surgery that has been totally invented by docs who are trying to raise their procedure levels and make more $$$. I have nothing good to say about bariatric surgery. There are studies underway that are already suggesting that the majority of people gain back weight and the mortality rate is shocking (when looked at > 1 yr)
So new protocols. Emphasis on well care and preventive health measures.
Like GreatDay I have to disagree with this statement. My mother had gastric bypass after battling her weight ..well most of my life. She gained hte most after my fathers death (due to depression) and she started having numerous health problems. I believe she had to be about 100lbs overweight to get it.. and she was just at that mark. It has been5 years now since she's had the surgery and I have to say that she is so much healthier than she's ever been.. and her weight is pretty stable. She eats better and takes vitamins. She's never been this healthy of a weight my entire life. She is also much happier and on much fewer medications than when she was obese.
BUT..I will say that this shouldn't be an 'easy way" to loose weight for people. It should be done for those who have tried and failed at many diets and other programs before having it. Now.. if we could all have BOB and JILLIAN..(reference to Biggest Looser.. in case you didn't know)we'd all be lean mean machines.
And I'm tired of the rhetoric and scare tactics that make Socialized Medicine program into a BAD thing!
Too many people can't grasp the fact that we're already paying for someone else's health care every time someone declares bankruptcy over overwhelming medical bills. They really can't grasp it. On Fox news every Saturday morning when someone advocates universal health the same funny looking critic always says, "I don't want to pay for your oxygen bottle." Or in response to a woman it's "I don't want to pay for your pap smear or your mammogram." Someone always says back that he already is paying every time someone declares bankruptcy. Yet this same thing repeats itself nearly every Saturday morning on Fox news.
Katiana - what is evidence-based care? Is this sort of like watching diabetics reduce their insulin intake as the disease is better managed? Is this watching cholesterol levels go down? Is this like case management on a larger scale?
Regarding pharma costs, I wish patents were granted for a shorter period of time, only enough to recover R&D costs for the product. The sooner the patent expires, the sooner the drug becomes generic, as well as the sooner competitors can produce the drug with the same ingredients. Competition will naturally reduce the price.
I would like malpractice insurance premiums reviewed/regulated in tandem with tort reform. It kills ob/gyns to fork out $130,000 a year in malpractice premiums. No wonder more are leaving the practice, and we can't afford for them to leave. Many ob's leave out the ob part and just practice gyn. Providers order a lot of procedures for fear of being sued for negligence.
Evidenced based care uses statistics and studies to determine most likely outcome, when different protocols are applied. (just my quick definition, LOL). For ex., a child presents w/ otitis media. Do you give him antibotics or use "watching waiting?" More often, docs are not prescribing antibiotics and are "waiting" to see if the earache will subside on its own, basing that approach on studies that suggest if you wait . . . the child will often improve on his own w/in 72 hours.
Docs don't always pay their own insurance premiums; they can be part of a larger pool of docs if they are employed by a hospital, and the hospital pays their premiums. Tort reform is the perennial discussion but how about, at the same time, reducing medical mistakes. Incorrect dispensing of drugs, hospital acquired infections, surgeon errors (including medical equipment being left inside patient) . . . these types of malpractice suits are legit and A. are inexcusable errors and B. should be compensated for.
Ah - drug patents. Shocking to find out that even tho our tax $$ fund the research of drugs thru/ NIH, the drug companies retain the patents - and then charge the taxpayers who funded the bill for pharma co's money-making drug outrageous amounts to buy that drug. That is beyond inane. Congress could do something about that, too. Most people do not realize that Medicare drugs costs ARE capped thru/ contracts w/ pharma companies. ALL drug costs could be capped. Thank your wimpy Congressmen for allowing the pharma lobby for jerking them around as to why nothing gets done.
Last edited by brokensky; 03-13-2008 at 05:29 PM..
Reason: misspell
the premiums for people in their twenties are reasonable, there are plans for $75/mo, as more people buy it the costs will come down and there are plans for people who truly can't afford it. They just don't want to buy insurance because they don't need it yet.
There are also subsidized programs for those making less than 30,000 as an individual and 68,000 for a family. A twentysomething making 30,000 can afford $75/mo. I agree that in many states and situations the cost is unaffordable, but part of the MA plan was to make it more affordable.
Tort reform is the perennial discussion but how about, at the same time, reducing medical mistakes. Incorrect dispensing of drugs, hospital acquired infections, surgeon errors (including medical equipment being left inside patient) . . . these types of malpractice suits are legit and A. are inexcusable errors and B. should be compensated for.
The medical association of anesthesiologists (or maybe orthos?) have already instituted their own watch-dog program to watch out for errors of their members. It is commendable that due to this program supposedly, anesthesiologists are no longer afraid to admit to their mistakes (at least this is what I read) to this watch-dog group so that in turn, they can look into reasons for the mistake, e.g. fatigue, wrong equipment lay-out, etc. etc. According to the article, errors have significantly dropped and so the malpractice premiums have correspondingly followed. Hopefully, more specialty groups follow this lead, not only protecting the consumer, but also decreasing the cost of malprac premiums which contribute to the cost of HC delivery.
The medical association of anesthesiologists (or maybe orthos?) have already instituted their own watch-dog program to watch out for errors of their members. It is commendable that due to this program supposedly, anesthesiologists are no longer afraid to admit to their mistakes (at least this is what I read) to this watch-dog group so that in turn, they can look into reasons for the mistake, e.g. fatigue, wrong equipment lay-out, etc. etc. According to the article, errors have significantly dropped and so the malpractice premiums have correspondingly followed. Hopefully, more specialty groups follow this lead, not only protecting the consumer, but also decreasing the cost of malprac premiums which contribute to the cost of HC delivery.
Excellent point and thank you for expanding on what I was thinking . . . yes, lowering errors goes hand in hand w/ lower premiums. It can be done! Thank you, Bibit, for once again providing some factual, insightful info to the discussion.
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