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Started By
Message
Posted on 7/20/17 at 10:13 am to MSMHater
quote:
Another important reason I don't think single payer will ever be implemented here. Who are you gonna sue when all the healthcare entities you frequent are run by the government?
That's not single payer.
Posted on 7/20/17 at 10:44 am to WaWaWeeWa
quote:
Would the feds really be the defendants? Wouldnt they just be the "insurance company" aka the third party payer
In theory, yes. But I don't think it would ever get to them being the defendant. I believe healthcare entities that treat single payer or public option patients will get some measure of tort protection if they are to effectively ration care (i.e. not practice defensive medicine) on behalf of the government.
quote:
You can't sue Medicaid right now for a bad outcome
Exactly like that.
This post was edited on 7/20/17 at 10:47 am
Posted on 7/20/17 at 11:33 am to WaWaWeeWa
Completely bogus. I live in Germany and pray daily that I don't have a major medical incident here ,because the hospitals here suck and the doctors are subpar and it is the same throughout Europe.
Posted on 7/20/17 at 12:01 pm to WaWaWeeWa
It will be a challenge to maintain enough providers if you are going to reimburse them for all their services at the Medicaid level.
I'm always against raising taxes. There is no end to it.
I'm always against raising taxes. There is no end to it.
Posted on 7/20/17 at 12:02 pm to TigerDoc
quote:
Unless you care about fairness.
Fairness is in the eye of the person wanting someone else's money.
Posted on 7/20/17 at 12:41 pm to MSMHater
What has resulted in the increase in costs in 1980?
Doctor's salaries haven't increased much compared to 1970-1980 when you consider inflation
What has increased is:
Regulations
Number of administrators
Cost of medical devices
Cost of drugs
Is there anything I'm missing?
Doctor's salaries haven't increased much compared to 1970-1980 when you consider inflation
What has increased is:
Regulations
Number of administrators
Cost of medical devices
Cost of drugs
Is there anything I'm missing?
Posted on 7/20/17 at 12:43 pm to WaWaWeeWa
Utilization. I think you are missing utlization. That's the largest part of the puzzle.
This post was edited on 7/20/17 at 12:43 pm
Posted on 7/20/17 at 12:54 pm to roadGator
But we have lower utilization than the European countries (if you are talking about number of doctors visits)
Posted on 7/20/17 at 12:56 pm to WaWaWeeWa
quote:
Regulations
Number of administrators
Hand in hand. I exist b/c of the former.
quote:
Is there anything I'm missing?
I would agree with Road, utilization/overutilization is missing.
Defensive medicine and financial incentive being the primary drivers behind it, IMO.
ETA: To expand on Road's point: Utilization of labs, imaging, beginning and end of life therapies, cancer therapies, experimental therapeutics, new pharmaceuticals, etc...
This post was edited on 7/20/17 at 1:00 pm
Posted on 7/20/17 at 1:26 pm to MSMHater
quote:
To expand on Road's point: Utilization of labs, imaging, beginning and end of life therapies, cancer therapies, experimental therapeutics, new pharmaceuticals, etc...
I agree with that definition of over utilization
But aren't those things what drives innovation and advancement?
Think about preterm babies as an example...
At first saving a 30 week old probably could have been argued as being wasteful. Now we are saving 26 week old babies and it is easier and cheaper to save 30 week old babies. That's innovation and advancement. I'm not here to debate whether it is worth it or what is moral and immoral.
Labs and imaging are due to defensive medicine
I guess my thoughts are that we need to:
- Reduce regulations
- Tort reform
- Streamline billing with a standardized system of payment
- More aggressive ability to negotiate with device manufacturers and drug companies. We need to demand prices closer to the European countries. Let the device companies figure out how to bring products to market for that price point, this will prevent R&D for worthless iterations of the same drug. Why do we need 100 different biologics, or 15 different cholesterol medicines just because one has 40% side effect of itching rather than 50%?
- Reduce insurance plans to cover extraordinary events and make patients have a higher stake in payment for outpatient visits procedures outside of routine primary care visits
Posted on 7/20/17 at 1:29 pm to WaWaWeeWa
quote:
What has increased is:
Hospital revenue
Why pharma draws such ire while hospital price increases are virtually ignored has always been a mystery to me.
Posted on 7/20/17 at 1:31 pm to WaWaWeeWa
quote:
More aggressive ability to negotiate with device manufacturers and drug companies.
What is your expected savings here? And I mean in real dollars.
Posted on 7/20/17 at 1:34 pm to WaWaWeeWa
quote:
know this is a totally bogus study. Will anyone here dispute that?
I know one difference is the we way count infant mortality rates.
We count miscarriages or children who died shortly after birth in the mortality rate, I know most of these other countries don't.
Posted on 7/20/17 at 1:39 pm to WaWaWeeWa
quote:
Reduce insurance plans to cover extraordinary events and make patients have a higher stake in payment for outpatient visits procedures outside of routine primary care visits
I will say that as young Mom in a city where I really didn't know anyone I ran my children to the doctor for every little sniffle. It was worth the 10.00 co-pay.
You hear horror stories and are scared witless. I think more could be done on educating parents on the day to day things. Like a runny nose and low grade temp.
Posted on 7/20/17 at 1:49 pm to the808bass
quote:
Among prescription drug costs, we pay far more than any other country, at least 20% more than Canada and over 60% more than New Zealand. For the same MRI’s and CT scans, we also pay more: $1,080 is the commercial average cost for an MRI in the U.S. as compared to $599 in Germany; at CT of the head costs $510 on average in the U.S. versus $272 in Germany. For a hip replacement, we again pay the most: $1,634 among public payers and $3,996 among private payers, versus $1,046 and $1,943 respectively in Australia.
So I just did the math (we order 109 MRIs per 1,000 Americans) and if we saved $400 on each MRI we would save 13.9 billion.
I'm sure we could find similar savings for other aspects of healthcare as well, prescriptions drugs being a big one
Posted on 7/20/17 at 1:57 pm to WaWaWeeWa
$14B is a nice start. It's a tad more than the USS Ford cost to build.
$3.2T is a massive number.
$3.2T is a massive number.
This post was edited on 7/20/17 at 2:00 pm
Posted on 7/20/17 at 2:00 pm to redandright
Separating the consumer from the true cost of healthcare is one of the reasons we are where we are. ACA did nothing about that in my opinion. In fact, it made it worse.
Posted on 7/20/17 at 2:01 pm to WaWaWeeWa
The numbers on CT scans... Would save 18.6 billion
Slightly off topic but if we reduced all 203,000 primary care physicians (includes pediatrics too) pay to that of Germany we would save 19.5 billion
So the difference we pay in one imaging study (CT scans) is equivalent to how much more we pay our primary care doctors
We haven't even talked about how much more we pay for:
Prescriptions drugs (arguably the biggest cost)
Cancer treatment
Medical devices
Etc.
Slightly off topic but if we reduced all 203,000 primary care physicians (includes pediatrics too) pay to that of Germany we would save 19.5 billion
So the difference we pay in one imaging study (CT scans) is equivalent to how much more we pay our primary care doctors
We haven't even talked about how much more we pay for:
Prescriptions drugs (arguably the biggest cost)
Cancer treatment
Medical devices
Etc.
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