OT: Health care struck down

Page 12 of 16  


There are a multitude of reasons for that and most of them have nothing to do with rather we have a free market system or a socialist system unless you want to aknowledge that we are much more likely to spend large sums on cosmetic healthcare.

By what measure? If you want to use that argument it also applies to everything else produced or supplied in this country. So go to India for your next doctors appointment or surgery. The doctors over there will be pretty good since they were more than likely trained here.

I am getting very good at BS recognition, you have been shoveling so much of it here that its easy to identify.

Gawd, you make shit up faster than I can keep up with. That is some claim, can you provide some proof to back it up.

How is the economy doing in all those socialist countries doing? Personally, I wouldn't have bailed out any of the companies that received them but the party in control of Congress decided otherwise. Who was that again?

Sorry but according to YOUR Source, it was 10% and that is a big factor.

70% higher? Please provide a source for that number and in comparison to what countries with comparison of the care provided.

Oh, now its 40-70% higher but again based on what? Just saying that we spend 40-70% more on healthcare based on expenditures without also comparing lifestyles, population mix, and other factors is a flawed analysis. The United States now has the highest obesity rate of any industrialized nation in the world. An estimated 300,000 people die each year from health problems related to obesity. Think that doesn't drive up our total healthcare costs?

Sorry, I don't and will never accept any argument for turning this country into another European Socialist Country.

Let me repeat, the SOCIALIST SYSTEMS ALSO RATION CARE and much more so than we do.

You do the same in regards to every socialist system in the world.

More BullShit from the bullshit artists of the socialist libturds.

Yes, based on your ignorance.

Well that make you a damn expert if anything could. Do any surgeries recently?

Which is what you seem to be doing.

You too or at least you are blind to any that doesn't go along with your socialist point of view. I am not a big fan of Insurance companies but I am far less of a fan of big government, especially big socialist government programs. I firmly believe it would wreak our healthcare and result in much higher costs and far worse standard of care. It is not something we can afford to experiment with. Just consider that everything else that our bloated government has tried to control they have totally screwed up.
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On Sun, 6 Feb 2011 16:50:35 -0800 (PST), BobR

cosmetic surgery is not covered by insurance.
and you still havent offerred a reason why our medical care costs 40-70% more than others.
the objective fact is that our free market system is less efficent than those that are not.
if you disagree, tell me the evidence supporting your position

% of GDP vs life expectancy and number of people covered
do you have a different system of measurement showing ours is MORE efficient?
If you want to use that argument it also applies to

germany, france, denmark, etc...none of these is india.
i'm not sure why you're trying to drag this up, since it hardly helps your case
you need evidence. where is it?

yes, those without evidence generally say evidence is BS. i've noticed that
where's your evidence?

yeah. our medical care is more expensive and less efficient than other countries without insurance companies
where's your evidence that i'm wrong?
it's a direct question based on easily accessed facts
where's your evidence??

actually pretty well
germany, highly uniionized workforce has 5% unemployment
meanwhile our GINI coefficient, measuring how much the rich have money, is WORSE in the US than virtually any country in the western world
hell, we have a profile like mexico!

the GOP. the architect of the bailout was henry paulson, sec of the treasury under bush.

great. i'm willing to use that number.
it's 10% wihch doesnt account for the fact our medical care is 40-70% more expensive than other countries'

OK. here you go:
http://www.nationmaster.com/graph/hea_tot_exp_as_of_gdp-health-total-expenditure-gdp
we spend 14% of GDP on healthcare
the NEXT CLOSEST COUNTRY is switzerland at 11% or about 30% less
austria...and i've been there...they have excellent healthcare...spends 7.6% or roughly HALF of what we spend.

OK tell me how different our lifestyle is from the austrians. i've been to austria. i speak some german. saw very little difference between our quality of life and theirs

now THAT is a good comment! unfortunately it doesnt bear close scrutiny:
http://www.nationmaster.com/graph/hea_obe-health-obesity
the US obesity rate is 30% (i used to be obese myself. now i'm 10 lbs overweight)....
BUT...the UK has a rate very similar to ours....and they spend about HALF of what we spend.
and switzerland, which is CLOSEST to us in spending, has an obesity rate about 75% less than ours.

yeah i know. evidence be damned, right. you have your mind made up, so dont confuse you with the facts

really? got proof?
we ration care for 30 million
uh...how do THEY ration care? they deny a heart transplant to a 95 year old?
gee. go figure.
we ration healthcare to the poor and to working people and to children
hey...if you're comfortable with that...

more propaganda. you have everything except an argument
where's your DATA??

where's your DATA? you're welcome to hurl all the insults you want. you're welcome to bluster all the right wing crap that makes you feel better about how the rich are screwing the country
me? i'll stick with the EVIDENCE

HAHAHAHA you said i was nowhere NEAR healthcare
NOW you're moving the goalposts!!
sorry sport. i tried to save a woman's life yesterday. aint nothing you can say that is gonna make me feel guilty about the volunteer work i do
ever do CPR in the back of an ambulance? had a cardiac patient vomit on you while doing chest compressions?
how much healthcare experience YOU have??

really? i presneted my evidence.
all you did was hurl insults and propaganda.
where is your EVIDENCE??
I am not a big fan of Insurance

where is your evidence
you have LOTS of words. LOTS of propgaganda. LOTS of insults
NO evidence.
none.
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On 2/6/2011 9:22 PM, bpuharic wrote:

http://www.nationmaster.com/graph/hea_tot_exp_as_of_gdp-health-total-expenditure-gdp
US Medical care hasn't been 'free market' for decades. If it were, there would be one price schedule for all patients, and you would have to file your insurance claims yourself. But since almost everyone has insurance, and the doctor's office files the paperwork, the patient never SEES the price, at least not until months later when they get the summary paperwork. So the patient regards the price as their co-pay, plus whatever uncovered portion they are billed for later. Most people have a short time horizon- they can't really mentally connect the premiums they already paid (and never saw in their bank account) to the check they write at the doctor's office. So, they perceive medical care as almost 'free'. Anything regarded as 'free' is overused and abused. To me, it seems very much like cars or hotel rooms- there is the 'official' price that would be charged to a cash customer (that almost nobody pays), there is the price that is billed to the insurance company, there is the lower amount that the insurance company actually pays, and there is the 'adjusted' price that the provider marks the work down to after the fact. This latter price, after they deduct what insurance company paid, is what they bill me for.
If the patient had to write the huge checks themselves (assuming a long enough billing cycle to get the cash from their insurance company), they might actually worry about costs. And if the medical care industry didn't have to play all these expen$ive paperwork games sending made-up inflated numbers to the insurance company, they might see that an actual price schedule would make life a lot simpler. ISTR the current system resulted from Kaiser shipbuilding (great grand-daddy to current Kaiser Permanante) using medical coverage as an end-run around salary caps in WWII.
Yes, I know, they have to harvest cash wherever they can to make their quarterly cashflow numbers, and to have enough extra to pay for all the Emergency Department visits by people who use that as their primary care provider.
I don't have an answer, but I know the current system isn't working.
--
aem sends...



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?

Our new policy has higher co-pays. Now my wife questions every test that will cost out of pocket expense. Is it needed? What will be gained or lost by not doing or delaying a test? Some doctors are quick to say "follow up in xx months when in reality, it can be double that time period.
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I had a situation a few years ago where they wanted to do a sleep study. They couldn't even tell me how much it would cost. "Don't worry, your insurance will pay it." *NO* one would tell me what it cost. I did it anyway, but learned nothing other than the entire system is a scam. ...and no, I don't believe the US government can do better. It's certainly proven the opposite.
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On Feb 6, 10:22pm, " snipped-for-privacy@att.bizzzzzzzzzzzz"

I understand you frustration with trying to find out what it would cost. I have become the go to person for prices by many of the clinics that deal with our department. Its not my job and I always give a disclaimer that the price I am giving depends on what the doctor ultimately orders and it could be different than what I come up with. (No, it really isn't part of my job and my boss has reminded me of that numerous times but I continue to provide the service while pushing to get something in place to provide accurate pricing.)
Pricing in healthcare is not based on the name of the procedure being performed but on a set of associated CPT codes that are generally not easily available to the doctors office or the person you are dealing with. They come to me because I built a cross reference database to support my own analysis work that ties the procedures to the CPT Codes and the price table which is maintained in a totally separate database that the doctors and clinics don't have access to. You can thank the government and Medicare for the CPT pricing methods and there are thousands of CPT Codes that are often so complex that it requires experts to decipher them. There was apparently a problem that you were having that prompted your doctor to at least explore the possibility of a sleep disorder. What was the value of that test? Nothing if it found nothing but then it did eliminate a possible problem. Was that worthwhile or not, you never know until after the fact. If it finds a serious problem it might have been worth a hundred times as much.
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wrote:

Sure, but those codes should have something to do with the procedure. No? ;-) As long as you're at it, tell me what the *exact* procedure is. Isn't that part of "informed consent"? [Note: not speaking to you, in particular]

No, it was a fishing expedition. I had a bout of A-fib (hospitalized a few days) and then a jump-start (cardioversion) a couple of months later. My cardiologist thought it was senseless to try to find a "cause" but the GP kept insisting on tests. I refused some which were clearly a waste of money; should have the same for the sleep study.
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wrote:

Oh they do but not always in the way you would expect. In some cases they are a one for one and an accurate description but in others they are related to the method of performance and not the result. Your informed consent has to do with the procedure not the billing.

Damn GP, why didn't he read the instruction manual that came with you? Well, I am not a doctor but did stay at a Holiday Inn Express once. Can't disagree with either your cardiologist or your GP, the both have an opinion on what is best and both may be looking for your best interest. You did what every patient should do, listen to their advice but make your own best choices. It was one of those fishing expiditions that found the leukemia that my father-in-law had. It didn't ultimately save his life but it did give him an additional 3 years. All because he said he had been feeling a little tired during a routine checkup.
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wrote:

If they can't tell me *exactly* what tests they're going to perform why are they pretending that there is an "informed consent"? If that procedure has multiple billings isn't that fraud?

Yes, I did give the cardiologist more weight. No, I didn't think an AIDS test was worth my insurance company's money. I made the mistake of taking one battery of tests without asking the costs. My part of it was over $700. Of course, the cardiologist was right. They found nothing important, not even RA.

That's a little different.
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As to the second issue. Depends. For many things it is legal. For example, you will get two bills for X-rays. One for the X-ray machine, supplies, and the tech who runs the machine. Second one from the doc who reads the X-ray. There is some work toward bundling these into one bill.
--
"Even I realized that money was to politicians what the ecalyptus tree is to
koala bears: food, water, shelter and something to crap on."
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to one bill.

Single payor, not single payee. Canada pays for X-ray reading services separate from the X-ray itself, for instance. I think they have not raised it to an art form like here in the US.
--
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koala bears: food, water, shelter and something to crap on."
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US stands out as a nation having national law against negotiating for lower prices of government-paid prescription drugs in at least one big-ticket "government program". I suspect such law is lobbyist-bought.
(Please correct me if, where and how I got this wrong.)
--
- Don Klipstein ( snipped-for-privacy@misty.com)

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snipped-for-privacy@manx.misty.com (Don Klipstein) wrote:

Yeha, but that is actually the exception and not the rule. The vast majority of the federal money for the two M's there is no negotiation. THis is what it is take it or leave it. Many are leaving it. Interesting tidbit with Part D. With each company doing its own deal, the prices for medications for Part D participants went down substantially. Indeed, Part D is actually UNDER budget in the original CBO projections. For the first couple of years (before I lost interest, I probably should track it) enrollees actually saved around $1200 per year on average (from Centers for Medicare/Medicaid Services studies). Mostly due to .... wait for it... "Competition between plans for subscribers and tough negotiations with the pharm companies. Hard to say if the differences would have been better if the government had been able negotiate directly. There are at least as many indicators that it wouldn't have (for instance Congress' delaying of MCare cuts to docs EVERY year since the implementation of the Medicare Sustainability Act in '97). "The average mail-order Part D prices for a broad range of breakthrough therapies covered by five large national prescription drug plans (PDPs) were found to be as much as 20% lower than drugstore.com and 17% lower than Costco internet mail-order cash prices. These discounts equated to average Part D savings of nearly $137 per therapy per month compared to drugstore.com and $142 per therapy per month compared to Costco. "
--
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koala bears: food, water, shelter and something to crap on."
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On 2/10/2011 1:45 AM, Don Klipstein wrote:

This keeps coming up, and everyone ignores the actual explanation- if US Gov capped prescription prices, R&D done by big pharma would simply STOP. Drugs can be cheap in Canada, because US customers pay for the R&D, and the marginal cost of making 15% more of any particular drug is so low, it is essentially free money to the pharma companies.
Yes, big pharma is a high-profit industry, and a somewhere-in-the-middle price that held world-wide could still support the costs of R&D. But since so many countries insist on making medicine look like it is free to their citizens, it'll never happen. So our choices are to live with current drugs at a cheaper price, or foot the bill for developing constantly better drugs for everyone.
Standard disclaimer- I'm no fan of big pharma, and find some of their practices repugnant, like making trivial changes in a drug solely for purposes of extending the patent, rather than increased effectiveness. But I do understand why drugs can't be free. Those labs and the lab rats that run them are expensive, as is the FDA approval process.
--
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As it turns out, though, trivial changes may not be trivial in many cases. It is pretty well established, for instance, among Prozac and cousins that a different drug of the same class may actually work if another one did not. IIRC, there are other types that have the same thing where if one doesn't work another might. I am substantially less concerned about "Me-too" drugs than I was when I took my first Pharm class back in the early 80s.
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Err...excuse me for raining on your parade, but you might want to do a little research on how much of R&D is gubmint subsidized. Big Pharma likes to bleat about how long and expensive is the process of bringing drugs to market. But they never seem to mention the huge taxpayers' subsidy that goes into the process.
Drugs can be cheap in Canada, because US customers pay for the

Who said they should be free? I'll settle for reasonable and non- exploitative, with consideration for the poor.
Those labs and the lab rats that run them are expensive, as is the FDA approval process.
You'd rather do it on the cheap, like rush stuff to market, which Big Pharma is always scheming to do? Unlike the heroine who kept Thalidomide off the US market...
Those who do not study history...
HB

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Higgs Boson wrote:

I have done a little research and can find NO grants or government subsidies to big pharma.
Research grants ARE awarded to universities and the like and the National Institutes of Health does do basic research. But as to payments to the pharmaceutical industry, nope, not there.
Even in the rare case where a new drug is invented by, say, a university, it still takes millions upon millions (and years and years) for a pharmaceutical company to bring the drug to market.
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statements in this, they are basically putting the research budget of the NIH in the mix. THe NIH does a lot of basic research in the field, which is then usable by Pharm companies. Much like NASA and semiconductors, etc. Many Pharm companies would probably like the other major NIH-sponsored research to be done away with. They do a lot of work comparing medications.

And the University gets the royalty payments.
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koala bears: food, water, shelter and something to crap on."
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Once again though, you can thank your government in part for causing this situation. The doctors don't work for the hospital but work through the hospital facilities. If the Clinic or Doctors Practice is part of the hospital system then the hospital bills for the technical portion of the procedure being performed and the physician or physician practice in the case of radiology and pathology bill for the professional (physician) portion of the bill. In a global billing situation, the radiology or laboratory service is acting as an independent facility and they bill one bill. I won't go into all of the reasons why this is the case and part of it can be traced back to bad past practices but it is now the law and like it or not we are stuck with it.

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That wasn't what I meant. There are two entries for a procedure, depending on who I am (or the phase of the moon, I suppose), they bill me for one or the other.
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