Wrong. Maybe you got lost in the thread. To recap:
firstname.lastname@example.org posted: "... other than ensuring the accuracy and
universality of the record keeping, government shouldn't need to know
the content of those records."
I questioned the federal government's constitutional power to act in
that area: "Where in the United States Constitution does it say that
Congress shall have the power to enact laws regulating the accuracy and
universality of medical record keeping?"
I think there is no such authority.
If email@example.com or anyone else thinks the government should be able to
ensure (or otherwise regulate) the accuracy and universality of medical
recordkeeping, the burden is on those who advocate in favor of that
position to support it.
I was the IT manager of an family practice metical clinic that implemented
an electronic medical records system a decade before Obamacare was a
twinkle in Mit Romenys eye. Was very expensive to implement both in
capital costs and implementation. Why bother? Simply because it was the only
way for them to get vaguely timely payments from the insurance companies.
In many ways this provision of ACA is another benefit to the insurance industry.
Untrue. Do you realized that many specialist have been outsourced? Lab
results for anything other than the most trival tests are rarely done
in-house. Way too expensive to have an in-house equipement to do, say,
blood gases when you may only have to do a handful in a year. Do you
realize that the interpretation of x-rays and sonagrams are often done
by specialist many miles or even countries away?
Not that simple. My wife went into a hospital about 500 miles from home
on a Sunday when her regular doctor's office is closed. Would have been
nice to have some additional information.
Happens more than you think. Again, personal experience when my wife
needs her blood checked when we travel. My daughter had a CT scan at
our hospital about a mile from us, but the results came from a doctor
that read the scan 250 miles away at a Philadelphia hospital.
While the government does not need to be involved, having access can be
life saving. Perhaps a person could carry an electronic key to be used
Yes, the list does go on and on... As the ultimate payer for Medicare and
Medicaid the government has and will continue to collect medical data on
anyone covered under those programs. With subsidies under ACA they also now
have an interest from the payer perspective for commercial lines of
business. They use the medical encounter data to ferret out fraud (which
historically has been rampant) and they also monitor the quality of care
providers render. Under CMS's Stars program the insurance companies are
reimbursed based on the quality of care their providers render. As such the
plans analyze the encounter data and undertake provider education
initiatives so that providers follow best practices. Members shopping Docs
to obtain drugs are also identified through the data. You may have heard
about insurance companies terminating contracts with thousands of providers
recently... the vast majority of those cases were the result of the provider
not following best practices, i.e., rendering inadequate care, often despite
years of interventions by the plans.
Self funded plans (where a company pays the claims themselves) have an
interest in improving the care and health of their employees also. While
they don't see the individual employees' data they do see aggregated data...
they want to see an improvement in their employees' health over time. This
improvement comes about as a result of health improvement programs (e.g.,
stop smoking, exercise, nutrition) and through high quality preventative
Regarding privacy in the U.S... we have no privacy. Whether it's health
data, surveillance cameras, credit card transaction data, loyalty programs
at stores, education systems, internet, TV and phone utilization records...
we are all under surveillance with or without government involvement.
He didn't say that or even suggest it. It was just a statement of
fact. You seem to believe that allowing or disallowing another
technology improvement is going to change something. It won't. The
horse is so far out of the barn on that one that it's in another
Nevertheless, I do understand the need to fight against every little
incursion on your privacy, if only just to marginally slow it down or,
at the very least, get your displeasure known.
As far as digitizing medical records go, I'm all for it. The
advantages far outweigh the negatives as far as I'm concerned. And,
considering that I've had years of extensive contact with our medical
system, (Canadian in this case), I am fully aware of all the negatives
Obviously, we're not agreeing to what "online" means. When I say
"online", I'm not for one second suggesting that records put made
available for any medical professional to see at the click of a mouse.
Sending records across the country at the speed of an electron *IS*
putting them online, if only for the time it takes to send those
records. Electronic transmission is an online process as far as I'm
My daughter manages a dental office. It was bought by the present owner
for over $1million. You can be sure this guy has a big nut every month
too. She just left for vacation so I can't verify the prices right now.
Fillings seem high though.
Prices vary. I went to one guy for cleaning. He wasn't my usual dentist
but she is a considerable distance away. He advised me I needed to have
"deep cleaning". I don't recall the price but it was in four figures. I
declined and checked with my regular dentist...her price was 1/4 his.
Your prices do seem high but I've had very little contact with dentists. I
only have two small fillings and I didn't have any until I was about 75. I
don't recall the price for them but I guarantee that the cost for both was
well under $525.
Check around...call and ask price info for fillings and crowns.
Here's a site saying $75-$150 for silver fillings.
About two years ago, I went to a dentist who recomended a deep cleaning.
Within a week I had an infected tooth which I lost a couple of months
I am nearly 70 and have never had problems with my teeth, and only have
about a half dozen minor filling. So the net results of the deep clean
I was up about 1000 for the cleaning plus the cost of the dentist
associated with the removal of the tooth.
A lot depends on the dentist. A local "Modern Dentist" sent flyers
for $29 cleaning plus X-rays and pictures with a free electric tooth
brush. The results were I was not eligible for that cleaning because
I had periodontal disease so I needed their $1000 cleaning. There
were 2 crowns they would like to replace at $2000 each and 3 fillings
for $400 each. The pictures were first class, the 3d x-rays were
amazing. The office was high tech. I went elsewhere.
I went to an old fashion dentist. His office straight out of the
70's. Cleaning is $75. One crown has a small hole with the
underlying tooth is sound. If it becomes a problem he can fill it
through the hole. At 40 years old it is still perfectly sound. He
did 3 surfaces with UV cured acrylic material. It took an hour and he
charged $112. I have had literally hundreds of cavities filled using
this technology with out a problem.
The first dentist I went to had a foot powered drill. He peddled it
like an old sewing machine. About $1 per filling, but that was 70
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