Coronavirus General Discussion

[vnatale]

I searched for the post where WiseOne recently had stated how business has overtaken the actual delivery of medicine. I thought it was in this Topic but was unable to find it.

I wanted to ask her if she was familiar with this book:

The Price We Pay: What Broke American Health Care--and How to Fix It

https://smile.amazon.com/Price-We-Pay-A ... 147&sr=8-1

Just started reading it and read these highly illuminating five paragraphs in this preface, Looks like this is a book I'm going to quickly read!

Capture.JPG

Vinny

America's healthcare system is a national disgrace. I can't exactly pinpoint why it is so broken but I think I would simply refuse to pay any hospital bill I was sent. They could spend the next ten years harassing me and ruining my credit and I still wouldn't give them a penny. I feel bad for the doctors and nurses caught up in the middle of this. The thing that strikes me Everytime I've been to doctor is how complicated the billing process is...seems like an enormous waste of effort and manpower. Imagine if other services and products were sold in the same incredibly complicated way that medical services are.....its absurdly inefficient. I'm also surprised that in today's age we don't have the ability to consent to being included in a national healthcare database so that medical records don't have to be shuffled around between doctors

You pinpointed it!

Here was another example from the book.

Someone's father had a heart attack. His father had been visiting from France. The hospital told him he needed a procedure which they could do for $150,000. The father called his doctor in France and was told the same procedure there would cost $15,000. They told the hospital this $15,000 price and the hospital immediately reduced the price to $50,000. They said no. Then just as they were leaving the hospital they got another offer to do it for $25,000!

Another story is about C-sections. Makes life easy and predictable for the doctor but not as good for both the mother and the baby.

The book did all kinds of studies of procedures. In the case of C-sections they found that one particular doctor did 80% more than average C-sections on Fridays! Clearly putting his welfare / needs ahead of his patients.

All through the medical system there is predatory pricing, taking advantage of people at their weakest moments with NO price transparency.

All Congress does is just offer more money to pay for "health care" when it is just lining the pockets of those who profit from the system. It does nothing to provide better "health care".

Vinny

[Libertarian666]

I searched for the post where WiseOne recently had stated how business has overtaken the actual delivery of medicine. I thought it was in this Topic but was unable to find it.

I wanted to ask her if she was familiar with this book:

The Price We Pay: What Broke American Health Care--and How to Fix It

https://smile.amazon.com/Price-We-Pay-A ... 147&sr=8-1

Just started reading it and read these highly illuminating five paragraphs in this preface, Looks like this is a book I'm going to quickly read!

Capture.JPG

Vinny

I haven't read the book but I do know the answer to the implied question.
Since all the apparently insoluble problems are due to government intervention, the answer is to get the government entirely out of health care.

[WiseOne]

There are a lot of books and blog posts on the effects of inefficiencies and the many layers of profit motives in the health care industry. Happy reading Vinny!

On the individual doctor level, I find it very disturbing how the emphasis has shifted away from patient care and toward doing procedures & arranging things to maximize profits. The telemedicine revolution, for example, is not only saving the day for coronavirus, it's a way to turn generally unbillable between-visit telephone calls and unprofitable low-level followups to billable, low-overhead visits. There are many layers above this, e.g. highly publicized clinical trials that use clever statistical manipulation and are little more than ads for profitable drugs. Malcolm Kendrick, a GP in the UK, has written extensively about this.

A lot of this is driven by patients themselves. People generally want to be over-treated and over-diagnosed. What's the incentive for a physician to spend an unreimbursed half an hour explaining to a patient why they don't need procedure X, instead of doing the profitable procedure? Or writing for the requested prescription, blood test or scan so you can get the patient out of your hair and make them happy at the same time. Not to mention that a ticked-off patient might sue you. In so many ways our system is based on "the customer is always right". In a setting where the customer gets what they want without having to pay for it, it's kind of obvious that this has to be driving up costs.

That's why the ideal medical system in my book is Medicare for all - but only for truly catastrophic, expensive conditions. Routine stuff should be all cash out of pocket with no government or insurance company involvement. The argument that "people will forgo needed care if they have to pay for it" just annoys me, given the above. If a patient isn't convinced that care is necessary, they're going to forgo it anyway. We call that "noncompliance" and it's very widespread even in the Medicaid population that pays nothing out of pocket.

Thoughts for the day. I'm going to do my community gardening today and forget about all this. Lovely spring day.

[Libertarian666]

That's why the ideal medical system in my book is Medicare for all - but only for truly catastrophic, expensive conditions. Routine stuff should be all cash out of pocket with no government or insurance company involvement.

I've proposed this, although I didn't call it "Medicare for all". "Publicly funded catastrophic-only" seems more appropriate.

[dualstow]

-
How much is a human life worth?

PLANET MONEY has the number.

https://www.npr.org/transcripts/835571843

MALONE: And now it seems that people - politicians, mainly - are asking for the same kind of is-it-worth-it analysis for the coronavirus. And Betsey, watching this unfold over the last few weeks, she was like, OK, you want to run the numbers? I can run the numbers. Is it worth it to shut the economy down?

STEVENSON: As an economist, I don't say it's worth it at any cost. That's not true. I mean, we could die of something else - starvation. So it's not at any cost, but here, it's worth giving up a lot. It's worth shutting the economy down for three, four months because there are so many lives being lost.

[Tortoise]

LOL, Well that was fast...https://www.reuters.com/article/us-heal ... SKBN22D6HG

Newsom is a completely spineless bureaucrat with zero leadership ability. I hope CA residents either recall him or vote him out of office over how he overreached then refused to communicate and initiate an actual reopening plan with an actual schedule.

[Xan]

-
How much is a human life worth?

PLANET MONEY has the number.

https://www.npr.org/transcripts/835571843

MALONE: And now it seems that people - politicians, mainly - are asking for the same kind of is-it-worth-it analysis for the coronavirus. And Betsey, watching this unfold over the last few weeks, she was like, OK, you want to run the numbers? I can run the numbers. Is it worth it to shut the economy down?

STEVENSON: As an economist, I don't say it's worth it at any cost. That's not true. I mean, we could die of something else - starvation. So it's not at any cost, but here, it's worth giving up a lot. It's worth shutting the economy down for three, four months because there are so many lives being lost.

That is a fascinating piece and well worth a read.

As an off-topic aside: I've never listened to NPR, and I read that article rather than listening to it, but one thing that jumped out was the gratuitous use of "like". Do professional radio people really say "like" that much?

[dualstow]

I'm glad you found it worthwhile, Xan.

To answer your side question: young people just don't know how to speak English, and all the things that curmudgeons like me complain about run rampant on talk radio. Vocal fry, bad grammar (e.g. "this is between her and I") and more like's than you heard from a valley girl in the 80s. To be fair, I have a friend who's over 50 and he says "like" even more than they do.

The finishing touch: the Spanish surname pronounced perfectly, natively, and quickly so that native speakers of English don't catch it.

[Dieter]

One way to get the count down.

Don't count non-residents

And then stop letting that count get our

https://www.salon.com/2020/04/30/florid ... her-total/

[vnatale]

I searched for the post where WiseOne recently had stated how business has overtaken the actual delivery of medicine. I thought it was in this Topic but was unable to find it.

I wanted to ask her if she was familiar with this book:

The Price We Pay: What Broke American Health Care--and How to Fix It

https://smile.amazon.com/Price-We-Pay-A ... 147&sr=8-1

Just started reading it and read these highly illuminating five paragraphs in this preface, Looks like this is a book I'm going to quickly read!

Capture.JPG

Vinny

I haven't read the book but I do know the answer to the implied question.
Since all the apparently insoluble problems are due to government intervention, the answer is to get the government entirely out of health care.

How does what you say fit in with the following, i.e., where it the government intervention?

Medical facilities can charge whatever they want. Prior to getting services you sign something saying you assume responsibility for paying for these services. You are not told what these services cost.

The book's analogy is you going to a grocery store. You pick up an orange. It has no price. But you are hungry and decide to buy it. The cashier charges your credit card $500. Their are no refunds.

That in a nutshell is the medical industry business. More medical business than medical care.

Vinny

[vnatale]

Reopening states will cause 233,000 more people to die from coronavirus, according to Wharton model

https://finance.yahoo.com/news/reopenin ... 49573.html

[Tortoise]

Reopening states will cause 233,000 more people to die from coronavirus, according to Wharton model

https://finance.yahoo.com/news/reopenin ... 49573.html

Guess we should stay locked down then. Who needs an economy?

[dualstow]

...
I'm also sick of bureaucrats deciding what is essential and what isn't.

I can't remember if you're one of the people who read The Mandibles, but your comment makes me think of the United States of Nevada near the end. Potential spoiler in white font: Closest thing to desirable anarchy I've seen in a long time.

[pp4me]

Reopening states will cause 233,000 more people to die from coronavirus, according to Wharton model

https://finance.yahoo.com/news/reopenin ... 49573.html

I'm waiting to see the model that shows the effects of NOT reopening.

As somebody above said, these headlines are getting tiring. They make me think of the movie "The Truman Show" and we are all Trumans.

[Libertarian666]

I searched for the post where WiseOne recently had stated how business has overtaken the actual delivery of medicine. I thought it was in this Topic but was unable to find it.

I wanted to ask her if she was familiar with this book:

The Price We Pay: What Broke American Health Care--and How to Fix It

https://smile.amazon.com/Price-We-Pay-A ... 147&sr=8-1

Just started reading it and read these highly illuminating five paragraphs in this preface, Looks like this is a book I'm going to quickly read!

Capture.JPG

Vinny

I haven't read the book but I do know the answer to the implied question.
Since all the apparently insoluble problems are due to government intervention, the answer is to get the government entirely out of health care.

How does what you say fit in with the following, i.e., where it the government intervention?

Medical facilities can charge whatever they want. Prior to getting services you sign something saying you assume responsibility for paying for these services. You are not told what these services cost.

The book's analogy is you going to a grocery store. You pick up an orange. It has no price. But you are hungry and decide to buy it. The cashier charges your credit card $500. Their are no refunds.

That in a nutshell is the medical industry business. More medical business than medical care.

Vinny

Why don't grocery stores behave like that?
Because they have competition.
Health care providers have a government-granted oligopoly, so they don't have to worry about competition.
Get rid of the licensure laws and other restrictive government rules and you will see a tremendous drop in prices.

[vnatale]

I searched for the post where WiseOne recently had stated how business has overtaken the actual delivery of medicine. I thought it was in this Topic but was unable to find it.

I wanted to ask her if she was familiar with this book:

The Price We Pay: What Broke American Health Care--and How to Fix It

https://smile.amazon.com/Price-We-Pay-A ... 147&sr=8-1

Just started reading it and read these highly illuminating five paragraphs in this preface, Looks like this is a book I'm going to quickly read!

Capture.JPG

Vinny

I haven't read the book but I do know the answer to the implied question.
Since all the apparently insoluble problems are due to government intervention, the answer is to get the government entirely out of health care.

How does what you say fit in with the following, i.e., where it the government intervention?

Medical facilities can charge whatever they want. Prior to getting services you sign something saying you assume responsibility for paying for these services. You are not told what these services cost.

The book's analogy is you going to a grocery store. You pick up an orange. It has no price. But you are hungry and decide to buy it. The cashier charges your credit card $500. Their are no refunds.

That in a nutshell is the medical industry business. More medical business than medical care.

Vinny

Why don't grocery stores behave like that?
Because they have competition.
Health care providers have a government-granted oligopoly, so they don't have to worry about competition.
Get rid of the licensure laws and other restrictive government rules and you will see a tremendous drop in prices.

3 states so far (Maine, New Hampshire, a third) have made mandatory that prices have to be revealed. And, there are new forms of insurance brokers and health care providers providing different models, which tilt more of the financial benefit to the patient.

How does what you say relate to all these helicopter companies being part of the health care $$$ crisis? They are not part of "government-granted oligopoly". You have the misfortune of ending up using their services and they give you a bill for $63,000. I call them now and ask for a quote for the exact same transportation services and they give me a firm price of $8,000.

I could go on and on and on with how it's a lot free (predatory) enterprise which has led to our health care crisis.

Vinny

[Libertarian666]

I searched for the post where WiseOne recently had stated how business has overtaken the actual delivery of medicine. I thought it was in this Topic but was unable to find it.

I wanted to ask her if she was familiar with this book:

The Price We Pay: What Broke American Health Care--and How to Fix It

https://smile.amazon.com/Price-We-Pay-A ... 147&sr=8-1

Just started reading it and read these highly illuminating five paragraphs in this preface, Looks like this is a book I'm going to quickly read!

Capture.JPG

Vinny

I haven't read the book but I do know the answer to the implied question.
Since all the apparently insoluble problems are due to government intervention, the answer is to get the government entirely out of health care.

How does what you say fit in with the following, i.e., where it the government intervention?

Medical facilities can charge whatever they want. Prior to getting services you sign something saying you assume responsibility for paying for these services. You are not told what these services cost.

The book's analogy is you going to a grocery store. You pick up an orange. It has no price. But you are hungry and decide to buy it. The cashier charges your credit card $500. Their are no refunds.

That in a nutshell is the medical industry business. More medical business than medical care.

Vinny

Why don't grocery stores behave like that?
Because they have competition.
Health care providers have a government-granted oligopoly, so they don't have to worry about competition.
Get rid of the licensure laws and other restrictive government rules and you will see a tremendous drop in prices.

3 states so far (Maine, New Hampshire, a third) have made mandatory that prices have to be revealed. And, there are new forms of insurance brokers and health care providers providing different models, which tilt more of the financial benefit to the patient.

How does what you say relate to all these helicopter companies being part of the health care $$$ crisis? They are not part of "government-granted oligopoly". You have the misfortune of ending up using their services and they give you a bill for $63,000. I call them now and ask for a quote for the exact same transportation services and they give me a firm price of $8,000.

I could go on and on and on with how it's a lot free (predatory) enterprise which has led to our health care crisis.

Vinny

What helicopter companies are you referring to? You mean air ambulances?
If so, you can subscribe to that service for a few hundred dollars a year.
As for "free enterprise" leading to our health care crisis, that is just absurd. There is no industry more in bed with government than the health care industry, so it should be obvious that free enterprise has nothing to do with the problem.

[Tortoise]

Guys, I love reading about and discussing the topic of U.S. health care, too, but don’t we have other existing threads for it?

[bedraggled]

Guys, I love reading about and discussing the topic of U.S. health care, too, but don’t we have other existing threads for it?

Agreed.

[vnatale]

Guys, I love reading about and discussing the topic of U.S. health care, too, but don’t we have other existing threads for it?

Where?

Vinny

[dualstow]

Guys, I love reading about and discussing the topic of U.S. health care, too, but don’t we have other existing threads for it?

Agreed.

Where?
Vinny

I didn’t know the answer, either, but I typed “health care” into the search box, and something magical happened:

Health Care During the Coronavirus Outbreak - viewtopic.php?f=9&t=10470&p=187920&hili ... re#p187920

DIYbio: the free market's answer to health care pricing - viewtopic.php?f=9&t=9888&p=175914&hilit ... re#p175914

Health Care Reform - viewtopic.php?f=9&t=9705&p=171465&hilit ... re#p171465

The Health Care Cartels - viewtopic.php?f=9&t=9693&p=171163&hilit ... re#p171163

Senate Health Care Plan - viewtopic.php?f=9&t=9093&p=162226&hilit ... re#p162226

What a Texas Town Can Teach Us About Health Care - viewtopic.php?f=9&t=6532&p=107992&hilit ... re#p107992

Why Health Care is so Expensive - viewtopic.php?f=9&t=6405&p=105723&hilit ... re#p105723

Health Care - viewtopic.php?f=9&t=5986&p=96901&hilit= ... are#p96901

There are more, but my cat needs brushing.

[vnatale]

Coronavirus: Packed New York parks are ‘slap in face to medics dying on frontlines’, says ER doctor


https://www.independent.co.uk/news/worl ... 1588602459

[shekels]

Coronavirus: Packed New York parks are ‘slap in face to medics dying on frontlines’, says ER doctor


https://www.independent.co.uk/news/worl ... 1588602459

Guilt Trip..we are not going to all stay Locked up until a Vaccine is released.
Masks and Social Distancing are just a suggestion in most areas.

[dualstow]

^ Love it
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

I can't imagine how isopropyl alcohol could lose potency. It's a fairly stable chemical compound.
Hydrogen peroxide, however, isn't very stable, so I wouldn't trust old H2O2.

I just read that bleach is only effective for 6-9 months. Darn. Our bleach is ancient.

Now I'm wondering about ammonia...

[WiseOne]

Coronavirus: Packed New York parks are ‘slap in face to medics dying on frontlines’, says ER doctor


https://www.independent.co.uk/news/worl ... 1588602459

Except that statistically, very few of the people in the parks are the ones showing up to the emergency room in respiratory distress from COVID. The rare cases of healthy young people succumbing are highlighted in the media, but they're a very small slice.

When you consider "the price of a life" there isn't going to be one number that fits all. It matters how many years of lost life you're talking about. For most of the COVID victims it's a few years, at most. The average COVID victim is 79 years old. Life expectancy at that age is on the order of 8 years (longer if you're a woman, shorter if you're a man). For COVID victims it may be a bit shorter since the sicker people in that population will be more susceptible. That's not nothing, but it's totally different from, say, a 40 year old dying. And maybe really hard to compare to the impact on the life of that same 40 year old by tanking the economy. I just wish a conversation like this could come through in news reporting, instead of the sensationalized "you will kill people if you go play in a park."

I was at my mom's house this weekend and there's a playground near her home. The jungle gym was wrapped in red plastic construction fencing by way of closing the playground. And, a single hobby horse on a spring (don't know what else to call it) which was at least 6 feet away from anything else and only supports one person at a time, was also wrapped up. Dumbest thing ever. I wish I got a photo of it. Maybe next week.