Page 3 of 3 FirstFirst 123
Results 51 to 75 of 75
  1. #51
    my unders, my frgn whites pgardn's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Feb 2010
    Post Count
    38,149
    Buffoon, you assume every new test available is useful AND better than existing tests. Not the case, and is well known not to be the case with patented drugs (eg, generic metformin vs new patented replacements)

    defensive medicine is part of the problem

    but cost and revenue pressures dominate in FOR-PROFIT health care

    some doctors have quit private practice to join clinics and hospitals, only to find mgmt considers them not to be doctors, but revenue centers will all the revenue pressure of private practice.
    I don't assume anything. I am telling you new tests come up that are better (give fewer false +) AND are more expensive.

    Defensive medicine starts with the individual taking care of him or herself and taking care of their children. You read the number of Hispanics that are prone to diabetes and heart disease in the OP's article yet continue to consume processed sugar and saturated fats. I live in San Antonio, it's rampant here as well.

    And the poor old folks that are constantly told by their physicians to stop a certain practice and they totally forget as no child is present to hear the instructions. I don't doubt some doctors are greedy and don't care, but others are continually frustrated by their patients.

  2. #52
    🏆🏆🏆🏆🏆 ElNono's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Apr 2007
    Post Count
    152,607
    When your average doctor's visit (note this has nothing to do with any testing or drugs, a mere office visit) costs 5x-17x what costs anywhere else in the world, and the standard of living difference is nowhere near as much, then something just doesn't add up.

    One other thing I noticed when I moved to the US is how little time a doctor actually spends with a patient during such a visit. Most of the work is actually done by a PA or RN (if one is even available). Pretty similar situation with dentists.

    That's not to say there are no exceptions to that, but that's my observation in general.

  3. #53
    I am that guy RandomGuy's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Jun 2005
    Post Count
    50,672
    What are the appropriate needs of each patient Dr. Buffoon? With more tests arising every week from medical technology which tests should and should not be run? Which are too expensive and way overdoing it and which are not?

    Oh so you did NOT run this test, and now the patient needs a more expensive surgery... And you did not run the test because you thought it was excessive and expensive, so, you missed the diagnosis Dr. Buffoon.

    But its easy for Dr. Boutons err.. Buffoon. Obviously there are clear cut cases, but there are many that are not. But it's all so black and white for the ideologue.

    Boutons will write the protocol for each patient based on information from the patient and the past medical history from each patient. Because it's all so easy to get and so easy to decide exactly which tests to run. We await your AMA manual Dr. Boutons.

    And this is only one problem...
    I'm with you on this one, mostly.

    Doctors are caught in a pinch, but I can tell you first hand from experience that doctor practices seem to me at least to be set up to milk the maximum revenue out of a patient for the least effort on the part of the doctor.

    I love my doctor, who is a wonderful, kind, and smart woman, but the business model of the practice she is stuck in... sucks monkey balls.

    We need to heavily subsidize med school, and pay doctors a fairly generous salary. Fee for service seems too likely to distort things, regardless of whether it does in reality. Even if you only reduce the appearance of impropriety, that is reason enough to change the system, IMO.

  4. #54
    my unders, my frgn whites pgardn's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Feb 2010
    Post Count
    38,149
    I'm with you on this one, mostly.

    Doctors are caught in a pinch, but I can tell you first hand from experience that doctor practices seem to me at least to be set up to milk the maximum revenue out of a patient for the least effort on the part of the doctor.

    I love my doctor, who is a wonderful, kind, and smart woman, but the business model of the practice she is stuck in... sucks monkey balls.

    We need to heavily subsidize med school, and pay doctors a fairly generous salary. Fee for service seems too likely to distort things, regardless of whether it does in reality. Even if you only reduce the appearance of impropriety, that is reason enough to change the system, IMO.
    Perfectly reasonable.

    I personally think its a good thing we are seeing more women doctors. My doctor is male and very good at explaining why he is doing certain tests and very good with the studies as well. But I ask questions that indicate I know the stuff. He gets a chance to show off his knowledge. He sees way too many patients imo.

    What happens to the people who are not proactive with their yearly checkup? What happens to the poor folks with a chronic problem that are not proactive because they just don't understand enough to ask good questions? They, and or their insurance, keeps getting milked. And I am sure my own doctor is good at rationalizing the large number of patients he sees everyday, just like in the OP's article.

  5. #55
    my unders, my frgn whites pgardn's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Feb 2010
    Post Count
    38,149
    I think a huge step forward would be requiring a health class everyday in elementary school. A health class in middle school. And a much more rigorous health class in high school where all the major body systems are studied for a full year. And we require a biology teacher, not a coach, to teach it.

    People must know more about their own body. Some people treat their body like a car, let the mechanic handle it. On the other hand there are quite a few males who know how a car works better than how they work.

  6. #56
    Veteran Wild Cobra's Avatar
    My Team
    Portland Trailblazers
    Join Date
    May 2007
    Post Count
    43,117
    When your average doctor's visit (note this has nothing to do with any testing or drugs, a mere office visit) costs 5x-17x what costs anywhere else in the world, and the standard of living difference is nowhere near as much, then something just doesn't add up.

    One other thing I noticed when I moved to the US is how little time a doctor actually spends with a patient during such a visit. Most of the work is actually done by a PA or RN (if one is even available). Pretty similar situation with dentists.

    That's not to say there are no exceptions to that, but that's my observation in general.
    Well, if you want lowered costs, we need serious tort reform.

    Let's take the example in post #44. I'll bet that the only reason Canada can sell them for less if that the agreement to sell at the lower price included that no lawsuits can come to haunt them. We are a sue crazy society. Drug manufacturers calculate a given percentage of the profits as going to pay for such litigation, hence the wholesale cost is higher here as well. I would be OK with people buying their drugs from Canada if at the same time, they sign away any right to sue the drug manufacturer.

  7. #57
    A neverending cycle Trainwreck2100's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Jul 2005
    Post Count
    40,646
    tort reform

  8. #58
    🏆🏆🏆🏆🏆 ElNono's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Apr 2007
    Post Count
    152,607

  9. #59
    Veteran
    My Team
    San Antonio Spurs
    Join Date
    Mar 2009
    Post Count
    97,514
    "that no lawsuits can come to haunt them."

    Canadians get killed and maimed and compensated for the same untested toxic drugs that kill and maim Americans.

    US drug mfrs spend twice as much marketing as they do on research and testing. New drugs, FDA accepting the drug mfrs own testing (negative results suppressed), are basically beta or alpha tested on unknowing, trusting patients.



  10. #60
    I am that guy RandomGuy's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Jun 2005
    Post Count
    50,672
    Well, if you want lowered costs, we need serious tort reform.

    Let's take the example in post #44. I'll bet that the only reason Canada can sell them for less if that the agreement to sell at the lower price included that no lawsuits can come to haunt them. We are a sue crazy society. Drug manufacturers calculate a given percentage of the profits as going to pay for such litigation, hence the wholesale cost is higher here as well. I would be OK with people buying their drugs from Canada if at the same time, they sign away any right to sue the drug manufacturer.
    LOL tort reform.

    Small part of a very large, complicated machine.

    http://heartland.org/sites/all/modul...pdfs/20309.pdf

    If you really want to get a better sense, start parusing the white papers on what drives the costs. it takes some sifting and everybody has their pet interests, but you are vastly oversimplifying the issue.

  11. #61
    dangerous floater Winehole23's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Nov 2008
    Post Count
    89,425

  12. #62
    dangerous floater Winehole23's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Nov 2008
    Post Count
    89,425
    the OP was based on Medicare stats, a new study reveals what's happening with thye privately insured:
    Differences in the number of tests and treatments given from place to place are still huge for the privately insured. But the cost of health care is like the cost of groceries—the total depends on the price of every item and on how many items you get. Both Medicare and private insurers have adopted policies and reforms that are reducing unnecessary tests and treatments and improving preventive care. In McAllen, as I wrote in May, such changes have saved Medicare an estimated half-billion dollars for that one community alone. But cutting costs for privately insured patients also requires addressing prices. And that’s a different matter entirely.


    When your grocery store is the only one in town, it can jack up prices without losing customers. The same goes for hospitals. The study found that hospital prices in monopoly markets are fifteen per cent higher than in those with four or more hospitals.


    It’s the Cost Conundrum Squared. The bigger the hospital, the more it can adopt systems that deliver better-organized, higher-quality, less-wasteful care. But the bigger the hospital, the more power it has to raise prices.

    We have a few ways out of the conundrum. We can regulate the prices hospitals charge insurers—this is what Maryland does. We can break up big hospitals. We can encourage hospitals to become the insurers. (That’s what Kaiser Permanente in California has done. It provides members with prepaid care at its hospitals and clinics.) Or we can expand Medicare to more and more people until we’re single payer.
    http://www.newyorker.com/news/news-d...undrum-squared

  13. #63
    Veteran
    My Team
    San Antonio Spurs
    Join Date
    Mar 2009
    Post Count
    97,514
    "We can regulate the prices hospitals charge insurers"

    no, can't do that. the (mythical) unfettered free market and compe ion always deliver the optimal solution (for BigCorp)

    "We can break up big hospitals"

    the opposite is happening. Hospitals are buying up hospitals, clinics, hiring independent doctors who are pressured by financial managers to deliver revenue, not care.

    Kaiser is a historical artefact, a non-profit that is extremely profitable.

    expand medicare? Repugs block expanding medicaid.

    single payer? ain't NEVER gonna happen, has been and will be blocked by the unstoppably powerful BigInsurer, BigMedicine, BigPharma.



  14. #64
    dangerous floater Winehole23's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Nov 2008
    Post Count
    89,425
    if people who believe otherwise take their marbles and go home, they cede the political field to those trying to screw them.

    is that what you want?

  15. #65
    Veteran
    My Team
    San Antonio Spurs
    Join Date
    Mar 2009
    Post Count
    97,514
    if people who believe otherwise take their marbles and go home, they cede the political field to those trying to screw them.

    is that what you want?
    Whine Hole, it's already marbles GAMEOVER. Human-Americans, patients, customers, employees LOST BIG.

    I'd love to hear your path from where we are ed up now to the airy-fairyland at the end of that article.

  16. #66
    🏆🏆🏆🏆🏆 ElNono's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Apr 2007
    Post Count
    152,607
    I have family in the area (10 miles away from McAllen, TX actually), and the amount of piss poor service and corruption in the health services segment is repugnant. Places like Retama Manor in Weslaco (at least up until a couple years ago) were only interested in the govt checks, treated patients extremely poorly, had illegals with little to no medical training looking after patients and an amazing turnover rate for employees (not to mention having things stolen from patients' rooms all the time, or when two employees were busted for having sex in one of the rooms).

    Another fairly common occurrence around here is 'agencies' that 'hire' somebody in your family to do home care for you, paying them dimes while billing Medicare/Medicaid for the 'service' and pocketing most of it. My father in law (disabled) actually did not want to be part of that and couldn't get the 'agency' to stop calling him.

  17. #67
    Take the fcking keys away baseline bum's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Mar 2003
    Post Count
    93,157
    I have family in the area (10 miles away from McAllen, TX actually)
    But what does Reynosa have to do with health care in the US tbh?

  18. #68
    🏆🏆🏆🏆🏆 ElNono's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Apr 2007
    Post Count
    152,607
    But what does Reynosa have to do with health care in the US tbh?
    I was actually in Las Flores (Mejico) for the first time ever two days ago... chock full of winter Texans

    Reminded me a lot of Argentina

  19. #69
    dangerous floater Winehole23's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Nov 2008
    Post Count
    89,425
    Whine Hole, it's already marbles GAMEOVER. Human-Americans, patients, customers, employees LOST BIG.

    I'd love to hear your path from where we are ed up now to the airy-fairyland at the end of that article.
    you think we should all give up, go home and suck our thumbs?

  20. #70
    dangerous floater Winehole23's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Nov 2008
    Post Count
    89,425
    you're the ing apologist. you think the game is over. you'd cede the field to the mother ers without a fight.

    you're wrong.

  21. #71
    Veteran
    My Team
    San Antonio Spurs
    Join Date
    Mar 2009
    Post Count
    97,514
    you're the ing apologist. you think the game is over. you'd cede the field to the mother ers without a fight.

    you're wrong.
    it's (has been) GAMEOVER, Whine Hole.

    fight?

    I'm still waiting for your PRACTICAL path to (winning) the battle with the BigCorp and 1%.

    What steps do we take to stop the looting of Human-Americans by the 1%, by BigCorp, BigFinance, BigHealthcare?

    and of course the "steps" must include electing an unblockable "socialist" majority (aka For The People) in Congress.

    Gerrymandering, voter suppression, the VRWC/1%/Repug SCOTUS' "C-U $Bs in politics" have DISENFRANCHISED Human-Americans.

    Even the duped tea baggers and duped cosplay patriot "marans" are pissed that THEIR (1%-financed) Repugs can't, won't do for them, other than protect/enrich the 1% and BigCorp.

    Where do we assemble for the fight, Oh Great Fighter?

    Aren't you worried about the militarized, police/surveillance state, which already snoops on anti-war dissenters, like nuns.

    Those NSA/FBI/CIA/der-heimat-security Madame Defarges have knitted your name and "thoughts" into their wooly databases, ready to pounce.

    We can't even raise the minimum wage to $15 or $20 to lift 10Ms of We The People out of poverty in The Greatest, Wealthiest, God-preferred Country Ever In The Universe.

    America, after the anomaly of 1945 - 1975, has regressed to the historical mean of an oligarchy, the country owned, operated, ruled by a few wealthy people who will NEVER, have NEVER yielded power without your "fight".

    Where do we assemble?

  22. #72

  23. #73
    dangerous floater Winehole23's Avatar
    My Team
    San Antonio Spurs
    Join Date
    Nov 2008
    Post Count
    89,425
    We can't even raise the minimum wage to $15 or $20
    many cities have done it already, without the permission of the oligarchs. how could that possibly have happened in a wholly owned subsidiary like the USA?

  24. #74
    Veteran
    My Team
    San Antonio Spurs
    Join Date
    Mar 2009
    Post Count
    97,514
    many cities have done it already, without the permission of the oligarchs. how could that possibly have happened in a wholly owned subsidiary like the USA?
    nope, only a couple.

    Most as of 1 Jan don't go above $10, or $20K/year for 2000 hours, still deeply in poverty,needing taxpayer subsidy to poverty-wage businesses.

    $15 or $20 has be a FEDERAL minimum so cities, regions that pay more don't get screwed by slave, red states that pay $7.25. And Federal minimum has to be adjusted for cost-of-living by metro region.

  25. #75
    Veteran Wild Cobra's Avatar
    My Team
    Portland Trailblazers
    Join Date
    May 2007
    Post Count
    43,117
    Does it really make a difference on poverty if the minimum wage increases? I say, never has and never will. What difference does it make if a hamburger flipper now make $15 / hr. as his rent and food prices clime in the process? Then at the same time, our exports are moe expensive to sell, and imprts are relatively cheaper, causing more US job losses yet.

    Let those of us who do full circle thinking know when you plan to deal with the root problems of our society, instead of addressing things that your solutions will cause greater harm.

    Some workers across the city are left telling bosses to give them fewer hours at the higher wage because a full week’s earnings now puts them past the threshold for some welfare payments such as food stamps and assistance with rent.
    This is from a blog that didn't source it well, but it is a reality. There is no good bandage solution. The root problems need to be addressed, then supply and demand for wages will prevail.

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •