my platform as presidential candidate - what's yours?
POSTED BY: rue
UPDATED: Monday, June 3, 2024 14:50
VIEWED: 27072
PAGE 25 of 27
Quote:
Originally posted by SIGNYM:Quote:For whatever reason dentists still remain largely small practices which compete effectively with each other, not giant monopoly-style hospital-chain corporations.
Originally posted by 6IXSTRINGJACK:
At the end of the day, insurance ponzi schemes are what have made medical care completely unaffordable. If doctors were only able to charge reasonable prices that people could actually afford to pay since the beginning, then the prices wouldn't be where they are right now.
Just look at the dental industry as an example. Most insurance, even the best private insurance people can pay for while working good jobs, don't cover much dental costs at all outside of 2 checkups and x-rays. Even when it does, it's usually not more than 20 percent of any procedures beyond a tooth pulling or capping.
Dentures for $3500 with all the teeth pulled out though?
Doesn't sound like a bad deal compared to a 5 minute ball massage with KY jelly in the early 2000's that cost me over $3000 out of pocket when I had a lump and was worried that I might have had testicular cancer. Wouldn't even want to know what that would cost in 2019.
Do Right, Be Right. :)
Maybe the difference is that hospitals require so much more equipment: imaging equipment and laboratories and surgical suites and a phamacy that carries everything?
I dunno. Around here, most hospitals are giant complexes that sprawl thru multiple many-story buildings. The only one that I know is reasonable is (was?) a charity-based hospital started by the Catholic Church, it's still only one building and seems very well-run. But once you get past a certain size, then you need multiple layers of management to coordinate the multiple moving parts ... you need a director of pathology and a director of surgical services and the head of maintenance and the IT director and director of nursing services etc and THEY all report to the next layer up (chief officers?) which reports to the layer over that (hospital board, quality control...) and THEY report to corporate HQ... Seems like all I ever see nurses do is "charting". You can't have all of those moving parts w/o CYA paperwork!
-----------
Pity would be no more,
If we did not MAKE men poor - William Blake
You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY
I think the biggest reason is that when medicaid started the Government explicitly denied coverage for all things "oral". Insurance companies since then have hardly covered any dental, even in emergency cases and issues such as mine that will greatly impact overall health and longevity if the people can't afford to pay for it without insurance.
It's still expensive, but dental work is a downright bargain compared to health issues that are covered by insurance companies, medicaid and medicare. Dentists weren't able to raise the prices at magnitudes larger per year over inflation like doctors and hospitals were because they'd all go out of business with no customers that could afford their help.
Do Right, Be Right. :)
NOTIFY: Y | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME
2009 McAllen, Texas, the second highest per capita cost for medical care in the entire country
https://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum
McAllen is in Hidalgo County, which has the lowest household income in the country ... McAllen ... is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care.
One afternoon in McAllen, I rode down McColl Road with Lester Dyke, the cardiac surgeon, and we passed a series of office plazas that seemed to be nothing but home-health agencies, imaging centers, and medical-equipment stores. “Medicine has become a pig trough here,” he muttered. Dyke is among the few vocal critics of what’s happened in McAllen. “We took a wrong turn when doctors stopped being doctors and became businessmen,” he said.
When you look across the spectrum from Grand Junction to McAllen—and the almost threefold difference in the costs of care—you come to realize that we are witnessing a battle for the soul of American medicine. Somewhere in the United States at this moment, a patient with chest pain, or a tumor, or a cough is seeing a doctor. And the damning question we have to ask is whether the doctor is set up to meet the needs of the patient, first and foremost, or to maximize revenue.
NOTIFY: N | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME
2015 McAllen, Texas, an average per capita cost for medical care in the entire country
https://www.vox.com/2015/5/6/8560365/health-care-gawande-mcallen
This is partly a story about McAllen, and what happens to a city that becomes synonymous with bad health care. Doctors there, as Gawande writes, began to reevaluate the type of care they provided.
NOTIFY: N | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME
This is about the UVA story
https://www.washingtonpost.com/health/uva-has-ruined-us-health-system-
sues-thousands-of-patients-seizing-paychecks-and-putting-liens-on-homes/2019/09/09/5eb23306-c807-11e9-be05-f76ac4ec618c_story.html?utm_source=pocket-newtab
-----------
Pity would be no more,
If we did not MAKE men poor - William Blake
You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY
NOTIFY: Y | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME
So, I've been posting about healthcare and health for a long time (a small sampling is found below). And I've made the point a few times that the problem with US healthcare goes far deeper than who's paying for it.
It starts with medical schools and doctors, and goes up through for-profit hospitals and insurance companies and rapacious drug companies, and all the way down to disposable bedpan and non-sterile gauze vendors.
I've described it as a pool of cutthroats trying to take advantage of each other (for example, where the wheelmaker rips-off the wheelchair vendor, and the wheelchair vendor rips-off the clinic, and the clinic rips-off Medicare), but ultimately passing the costs on to the consumers/ taxpayers who get stuck for all of it.
I started profiling the differences between Canada and the US regarding medical schools, tuitions, per capita number of doctors, percentage of specialists, how doctors are compensated, and even 'what motivates doctors'.
And I don't think our problems are entirely structural and fixable by structural changes (even though many changes would deeply improve the situation, I can't think of any that are beyond gaming.)
And I think it's a legitimate ethics difference. In the US profit is king. Anything that makes a profit = good, anything that doesn't make a profit = bad, anything provided as a service = evil communism. It equates social value (even necessity) with money, when it's anything but. And in the US there's still a cachet associated with the title (rich) doctor. (As opposed to say a veterinarian or dentist.) Many people go to med school to GET RICH, and they're willing to put up with financial and personal hardship just to get there.
On top of that medical schools severely limit the number of students, and medical associations severely limit the number of residencies; AND both the residency programs AND the residents-to-be trend away from primary care and toward far more lucrative specialties. And that leads to a shortage of doctors society needs most, which are general practitioners; and an excess of specialists looking to make money off of their skills ... which is why the US has roughly 2x more knee replacements per capita than other industrialized countries. ( https://www.sciencedirect.com/science/article/pii/S1063458415011656) (And unnecessary, ineffective, and even dangerous surgeries follow trends - hysterectomies, tonsillectomies, gall bladder removals, ear tubes, back surgeries, arthroscopies ... and so on.)
The argument's been made that to change society we need to change what gets rewarded. And that would be an interesting experiment (though I'm at a loss as to how to configure that and implement it).
But I look at most doctors, and they're just - yanno - running the maze on their way to the cheese, preferably the biggest piece possible. Then you see some doctors like those at the Mayo clinic or the collective in Grand Junction - and they've made a deliberate decision to step out of the routine, to not focus on profit, and to get together as a group to get the patient truly well. (BTW - that was the original and is apparently the still-surviving MO of Dr. Mayo's very first practice.) And then you see the doctors of McAllen, TX pushing the profit motive to the max, and pushing the patients' welfares right out of the picture - not doing anything ILLEGAL, mind you. Just unethical. Charging literally the second most per capita in the entire US for medical care - 300% the national average for patients no sicker, not getting better care, and in an area not more expensive to operate in - in the poorest county in the country.
So, when it comes to those particular individual doctors in McAllen - if anyone wanted to - they could have been individually and specifically named and shamed. And after the article came out, I'm sure they experienced some collective embarrassment which is why they (apparently) changed their ways.
But the point is they felt no apparent sha
NOTIFY: N | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME
Quote:
Originally posted by SIGNYM:
This is about the UVA story
https://www.washingtonpost.com/health/uva-has-ruined-us-health-system-
sues-thousands-of-patients-seizing-paychecks-and-putting-liens-on-homes/2019/09/09/5eb23306-c807-11e9-be05-f76ac4ec618c_story.html?utm_source=pocket-newtab
-----------
Pity would be no more,
If we did not MAKE men poor - William Blake
You idiots have been oppressing the entire sexual spectrum as long as you have existed. I can't wait for the day your kind is dead - WISHIMAY
I was under the mistaken impression that you couldn't lose your house for medical bills, nor had your wages garnished.
If that ever happens to me, I'll quit my job. I'd rather starve to death.
Fuck them.
Do Right, Be Right. :)
NOTIFY: Y | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME
On to differences in hospitals between Canada, and the US.
http://www.cwhn.ca/en/node/39754
Although almost all Canadians believe hospitals are publicly owned and accountable institutions, under provincial legislation 95% operate on a non-profit basis. Most of Canada's approximately 850 hospitals are owned and operated by non-profit, voluntary organizations.
(Though de-listing services and departments, and outsourcing have allowed aggressive for-profit acquisitions. -1kiki)
https://www.beckershospitalreview.com/hospital-management-administrati
on/50-things-to-know-about-the-hospital-industry-2017.html
4. Out of total registered hospitals, about 20.2 percent are state-owned, 58.5 percent are nonprofit and 21.3 percent are for-profit.
FWIW I've worked in the VA, an extremely large county hospital, an extremely large for-profit private hospital, an extremely large non-profit private hospital, a private medical group, and a religious-owned community hospital.
And I have never seen such shenanigans as those at the extremely large for-profit private hospital.
NOTIFY: N | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME
I hope to continue with medical insurance companies.
“It was kind of mind blowing to realize that the country 50 miles away from where I live — that people could go to the doctor whenever they wanted and not have to take out their wallet.” B. Sanders And at half the per capita cost as in the US.
NOTIFY: N | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME
I just wanted to point out this one example of the totality of our medical care's systemic rip-off: Lazarus: When a hospital sling costs 900% more than Amazon’s price, something is very wrong https://www.latimes.com/business/story/2019-09-12/medical-equipment-pr
icing
It's not just medical insurance companies that need reform.
NOTIFY: N | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME
Medical Debt is Crushing Many Americans. Is the Health Care System on the Verge of Collapse?
As I've posted before, Obamacare is a failure when it comes to two statistics: death rates from chronic diseases which have edged up slightly under its full implementaton, and medical bankruptcy rates which haven't gone down. https://www.eurekalert.org/pub_releases/2019-02/pfan-6ob020719.php
Roughly 80% of people will get better whether they see a doctor or not, and whether that the doctor does anything or not - and that's because most doctors' visits are due to self-limiting conditions.
When you really need medical care is when you're managing a chronic condition, and when you're suffering from a serious accident or illness.
Obamacare - no it doesn't cover that. Obamacare makes sure you have insurance despite pre-existing conditions. And it mandates free screening for things like hypertension, diabetes, or breast cancer.
But getting treatment for those pre-existing conditions? Or for illnesses that might be discovered by your free screening? Or for anything else that might come up? And its cost?
That's between you and your insurance company.
https://www.theorganicprepper.com/medical-debt-is-crushing-many-americ
ans-is-the-health-care-system-on-the-verge-of-collapse/
Medical Debt is Crushing Many Americans. Is the Health Care System on the Verge of Collapse?
By Dagny Taggart
Health care expenses are a massive burden for many Americans, and for some, they can be financially devastating.
A new report from Kaiser Health News revealed some shocking examples of just how bad things can get for some people.
‘UVA Has Ruined Us’: Health System Sues Thousands Of Patients, Seizing Paychecks And Claiming Homes covers the cases of individuals who are dealing with serious financial hardship due to the University of Virginia Health System’s aggressive collection practices.
The article begins with the story of Heather Waldron, who required emergency surgery in 2017. She believed she had insurance at the time – it wasn’t until after her hospitalization that she learned a computer error involving the HealthCare.gov website caused a lapse in her coverage.
The UVA health system slapped Waldron with a lawsuit and a lien on her home to recoup the $164,000 in charges, leading to serious financial hardship for her family:
She is now on food stamps and talking to bankruptcy lawyers. A bank began foreclosure proceedings in August on the Blacksburg house she shared with her family. The home will be sold to pay off the mortgage.
She expects UVA to take whatever is left.
The $164,000 billed to Heather Waldron for intestinal surgery was more than twice what a commercial insurer would have paid for her care, according to benefits firm WellRithms, which analyzed bills for Kaiser Health News using cost reports UVA files with the government. Charges on her bill included $2,000 for a $20 feeding tube. (source)
Waldron is not alone. There are many stories similar to hers – and some are much worse.
The UVA Health System aggressively pursued patients for medical bills for years.
The Kaiser Health News (KHN) analysis found that during a six-year period ending in June 2018, “the UVA health system and its doctors filed 36,000 lawsuits against patients seeking a total of more than $106 million, seizing wages and bank accounts, putting liens on property and homes and forcing families into bankruptcy.”
People who have received treatment in the UVA system are facing a particularly formidable opponent. “UVA stands out for the scope of its collection efforts and how persistently it seeks payment, pursuing poor as well as middle-class patients for almost all they’re worth,” the KHN report explains. Court records, documents, and interviews with hospital officials and
NOTIFY: N | REPLY | REPLY WITH QUOTE | PERMALINK | TOP | HOME