Mayo Clinic (Glendale, AZ) announced today that they will no longer accept future Medicare patients, etc...
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...Jim Thompson
-- | James E.Thompson, CTO | mens | | Analog Innovations, Inc. | et | | Analog/Mixed-Signal ASIC's and Discrete Systems | manus | | Phoenix, Arizona 85048 Skype: Contacts Only | | | Voice:(480)460-2350 Fax: Available upon request | Brass Rat | | E-mail Icon at
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| 1962 | I love to cook with wine. Sometimes I even put it in the food.
Was listening to the radio today. I think that it was the substitute for Rush Limbaugh... They mentioned the Amish communities that put aside a cash reserve for health care. When someone needs medical care (at a hospital), they negotiate a cash price rate. This rate is substantially lower than the normal insurance rate.
What does this say about another layer of middlemen and bureaucrats that would only further raise the costs of care when government gets involved?
Obama care aside. It is pretty pathetic that insurance as it is increases the care provider's costs so. A while back I needed to get an orthotics device (drop foot brace) for my wife. Surgical supply store quoted something like $275. I balked but took out my checkbook. The owner thought a minute and reduced the price by almost 50% since I paid 'cash' and he wouldn't have to wait for reimbursement.
It's probably been mentioned before, but this graphic from that well-known lefty marxist rag, National Geographic (*National*, get it? How much more of an admission of a socialist -- or National Socialist -- agenda is needed? Scary stuff!) is pretty telling:
Are you sure they weren't claiming to negotiate a substantially lower rate than the normal *hospital* rate?
I mean -- insurance companies have plenty of incentive to negotitate very tight deals (more money for them), and they have a lot more leverage (many thousands of subscribers) they a few Amish do.
There is something to be said for hospital-run HMOs, though, where there's only one entity (the hospital) that needs to make a profit or at least break even rather than the more typical two (the hospital and the insurer).
The problem with simplistic graphs and explanations is precisely that they're baby talk simplistic.
For example, one of the reasons for the "unneeded treatment," as they put it, is ass covering for law suits due to the "absolute liability" principle U.S. courts have placed on the system. "Government" healthcare sure does solve that 'problem' because you can't sue the government and the 'remedy' is whatever the government, not a 'sympathetic' jury, decides to provide.
Whether you think that's 'better' is another matter but there are ways to improve the problem without government running everything.
Another is that equipment and treatment is much more readily available in the U.S., and that costs money. Another is that, in the U.S., 'heroic' effort at end of life is common, and that costs a heap of money. Now, whether you think it's 'better' to wait 6 months to see a specialist and that when you get a 'terminal illness' it's appropriate to just die off and get out of the way to 'save money' is a 'good thing' is a matter of opinion, and perhaps different depending on whether it's you who are sick or the government trying to meet budget.
There are other issues as well but the point is that simply comparing one country to another without going into the demographics (try breaking U.S. 'life expectancy' by demographics), underlying reasons, and causes is deceptive baby talk.
It doesn't say a lot about just "government". The Amish likely pay more than Canadians or the French. In both those cases the providers are private companies and the government pays them to provide the care.
Holding costs down is hard work. Raising rates is easy. Unless there is something requiring the insurance companies to increase profits the hard way, they will do it the easy way. Right now they are exempt from antitrust etc so they can work together to do it the easy way.
Of course socialized medicine is socialist. Why do its promoters cringe at that description? When I lived in Europe there were a number of people who thought socialism was a good thing, and they proudly called themselves socialists.
The caption says: Americans have shorter life expectancies. Yes, but for non-medical reasons.
The caption says: lack of insurance contributes to 45,000 deaths a year. Absolutely false--that's a bogus figure.
The caption says: we spend more on health care. a) If we did, is that by itself a bad thing? Maybe we want more stuff and we're willing to pay for it. b) I'm not so sure how much more we spend, if we do. We've all taken this as a given, but based on figures from unreliable sources. Knowing how sleazy our gov's figures are on this--just look at the current health bills--one wonders how upright the comparison gov's are. c) Milton's comment in that article is intriguing--the OECD doesn't report costs in US dollar equivalents, but after a giant fudge factor. (e.g. Milton says the UK counts UKP 1 as US $1.60, but as only $1.10 worth of healthcare.) d) The euro's jumped. Have the European costs been adjusted upwards accordingly?
The caption criticizes fee-for-service. Agreed--it creates a bogus incentive, the incentive to produce a lot of line-item charges rather than fix the patient's problem. Not fixed in the current bills. Who benefits? The AMA. They own the copyrights to the billing classification system--those procedure codes your doctors check off-- and get big royalties from it.
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Another view on those codes, and how the AMA misuses them to raise the cost of care:
Mayo Clinic performance rating comes under scrutiny
"The White House has praised the Mayo Clinic and other Midwest clinics for performance ratings, but critics argue that Mayo's low- to no-acceptance of Medicare/Medicaid skews the results.
Critics say the high scores in the Dartmouth College rankings do not reflect Mayo's refusal to accept Medicare for patients in its Arizona facility or that only five percent of patients in its flagship Minnesota facility are on Medicaid.
The clinics have collectively leveraged their high-performance rankings, critics say, to insert favorable language in healthcare legislation provisions to reward themselves with higher Medicare payments. The language would also punish facilities with low rankings--primarily in the South and in larger U.S. cities."
Looks like their plan to sucker legislators suckered you.
It was given away to the republicans. They will not pass a bill containing it, same as they crippled it for medicare meds. No negotiating based on scale on the republicans' watch. lol
In fact you can sue for negligence and it does happen outside the US. Few legal systems are as over-provided with lawyers as the US and lawyers outside the US tend to want to b paid up-front, rather than being prepatred to work for a proportion of the eventual damages.
Medical liability insurance in the US is lot more expensive in the US than anywhere else - when I was in medical electronics in the late
1970's, it was claimed that half what you paid to US doctors went to cover thier malpractice insurance - and it does seem to be one of the less admirable features of the culture.
Various states have tried to set up "no fault" compensation systems, which save the court costs and reduce the payouts for the more tear- jerking claims, but the lawyers don't want to lose the income and - surprise, surprise - the legislation has been thrown out by the courts.
The French, Dutch and German systems aren't short of equipment, but it isn't used quite as frivolously as it is in the US. In the late 1970 individual physicians were buying a couple of million dollars of X-ray body scanner, figuring to be able to push enough of their patients through the machine at the rate of couple an hour to cover the interest on the investment and make a decent profit; X-ray body scans were then rather too low resolution to be generally useful, but everybody could understand the pictures, even if they were only excluded a few relatively low frequency conditions.
The long waiting lists to get to see a specialist did happen - to some extent - in the UK when Margaret Thatcher was trying to cripple the National Health Service to force everybody who could afford it into US style private health insurance, but it was corrected - tolerably quickly, when her Conservative administration was finally thrown out, back in 1997.
It doesn't happen in the French German and Dutch systems.
"Heroic efforts at the end of life" don't make a lot of economic sense for the community, and they don't do that much for the patients, who don't actually enjoy the heroic efforts all that much, but they do make a bundle of money for the medical practitioners involved, who can trot around blackmialing the family with "your money or their life" stories.
One of my friends died of leukemia. Chemotherapy was known to offer very little chance of cure in his case, and the rational response would have been to skip it, but he was pressured "not to give up" - by his kids, not his Australian doctors - so that its was a perforated ulcer, brought on by the stress of the chemotherapy, that killed him , rather than the leukemia. It didn't make any difference to his survival time, but the chemotherapy was pretty unpleasant, while it lasted.
Not as deceptive as trying to deny that the US medical system is outrageously expensive and doesn't deliver any extra value for the extra money.
Perhaps. Obesity isn't - strictly speaking - a medical problem, but there are medical treatments for it that do work.
Not necessarily. People without insurance tend to avoid seeing their doctors until their problems are painfully compelling. Early treatment is cheaper and has better outcomes than treatment initiated when disease is well-established.
There has been a claim that the unisured die earlier because they are sicker to start with; apparently if you compared unisured smokers with insured smokers (who are a smaller proportion of the insured population than uninsured smokers are of the uninsured population) the increased death rate largely goes away
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deaths-totals-uninsured/
but this does neglect that fact that healthy people can get their insurance cheaper than those with evident health risks, and part of extra health care thye insured get nvolves advice on avoiding unhealthy habits and activities.
But you can get the same stuff in France and Germany for about two thirds of the price.
The French and German health care payments come from a heatlh insurance system that isn't part of the government, even though it is fairly closely regulated by the government - their figures are regular business financial reports.
The usual figure for comparison is the proportion of the GDP devoted to health care. This neatly avoids exchange rate problems.
The usual figure for comparison is the proportion of the GDP devoted to health care. This neatly avoids exchange rate problems.
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The AMA is a medical trade union. Their take on medical education has been described as imposing professional birth control. They are definitely part of the problem.
One of my cousins practices as a medical specialist in the US. He worked in Australia as a medical professor for a few years, fairly late in his career, but the money wasn't anything like as good as it had been in the US.
It is a combined graph of cost, life expectancies, and 'number of visits' and cutting 'cost' spent for 'marginal return', meaning the elderly and young, is precisely the mechanism espoused by Obama appointees in their writings..
This illustrates the problem that all of the current approaches to "the healthcare mess" seem to share. In practically every case, the problem has been sold to the public as one of how to get more people covered with no concerns for the pricing powers of the providers.
Every news story I've seen has been about those big, evil insurance companies denying coverage (or pricing it out of reach) of the poor folks. But insurance companies are heavily regulated, so the premiums they charge just reflect the prices that they have to pay the providers. Meanwhile, any moves to allow for single payers systems (the public options) or insurance companies pooling their purchasing power to get better pricing out of the providers has been fought by those providers. And that hasn't made to news to the same degree as the behavior of 'big insurance'.
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Paul Hovnanian paul@hovnanian.com
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Have gnu, will travel.
That's because 'insurance companies' are who Obama chose to make the bugaboo 'bad guy'. Well, along with the fabrication of doctors wantonly lopping off body parts and ripping the tonsils out of innocent children. And, remember, failure to 'reform' healthcare was claimed as a 'cause' of the financial crisis despite no one being able to explain how health insurance caused financial institutions to purchase junk securities.
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