So, The Guy That Made The Decision.......

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Spence
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Re: So, The Guy That Made The Decision.......

Postby Spence » Sun Feb 10, 2019 11:52 pm

billybud wrote:Interesting reading...

https://healthcareinamerica.us/we-all-w ... 6a0cb45253


I think most people believe that the business model is bad. All the tests that Doctors order is to protect themselves from lawsuits. Fixing that would be a good start. People sue if they get a bad outcome. We tend to look at everything in hindsight without considering what was going on in the moment. If a doctor is negligent there should be a process to penalize and if needed revoke his/her license. If that doctor did things right and foreseeing the problem wasn't something he should have in the moment then he should not be held to an impossible standard. Still just fixing tort, would not solve the problem.

As far as insurance is concerned, this I know for sure, whenever the government has required insurance the price goes up. I am paying upwards of $4200 a year in car insurance for me, my wife, and two of my kids. It used to be liability insurance was cheap. Full coverage costed more. When the government required everyone to have insurance liability went through the roof. The same people who didn't have insurance before, still do not have it. You can't get blood from a turnip. The more that government requires, the higher the cost of what they require.

I'm not smart enough to know how to fix the problem, but if I know if my car insurance was half what is is now and I could get insulin under $1500 for 3 months, I would have a pretty good nest egg.

I understand I have to pay for my daughter's illness and that should not fall on my neighbor to pay. I just think that when it comes to a product like insulin, a price more in line with the cost of the product would be fair. Actually 5 times the cost to produce would be awesome.
"History doesn't always repeat itself but it often rhymes." - Mark Twain

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Re: So, The Guy That Made The Decision.......

Postby donovan » Tue Feb 12, 2019 4:51 pm

The solution is not simple and the changes needed have long been known. There is room for argument of what part the government should play, but with government involvement, which personally I think keeps anything from changing, or without, the principles to me are the same.

A. Care should be centered on what patients need and not the specialties of the providers or how they are reimbursed. When something goes wrong with our bodies, nothing is independent. Co-morbidities need to be addressed and that is best done not through specialties but by comprehensive attention.

B. Standard costs need to be determined. That data is available but not used. A hip replacement costs 'x' amount. That is known, but to use that figure would lower the cost to the patient. Not something corporations want to do.

C. Reimbursement for services should reflect the actual cost of the service and should be bundled. Unbundling prices seems like transparency but it is actually the opposite and drives up costs exponentially. You have a knee replacement it should cost a fixed amount. Includes everything related to hip replacement, You have your car fixed, they look in a book and charge you that. Time, parts, etc are figured in. Medicine can do the same.

D. Treatment should be in fewer large systems. They may not be as close to home, but overnight stays, travel, etc can be figured in. Better care at a lower cost. Don't forget, it is the delivery system that is broken, not the care.

E Electronic Health Records need to be made available to everyone involved. Reduce duplicity.


Pharmaceuticals are a separate issue. Here is the issue. Modern development happens because of research which costs thousands. Much of that is supported by Tax dollars. If taxes are used then the benefit of the research needs to be made available to those that finance it, the taxpayer. This is how it works. The research company, when developing meds no longer own the patents when tax dollars are used, the government does and it is made available to the public without cost. The manufacturer's cost is merely the cost of making the pills. If tax dollars are not used, then the cost is what it is but I can tell you without tax dollars there will be minimal research. Investors cannot get a return on their dollar. I am not for government intervention, but we have to be pragmatic.
"No, no!" said the Queen. "Sentence first–verdict afterward."
"Stuff and nonsense!" said Alice "The idea of having the sentence first!"
"Hold your tongue!" said the Queen, turning purple.
"I won't!" said Alice.
"Off with her head!" the Queen shouted at the top of her voice."

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Re: So, The Guy That Made The Decision.......

Postby Spence » Tue Feb 12, 2019 9:59 pm

That has always been my issue with Pharmaceuticals. If they use tax dollars to fund most or part of the research then why do they need to charge unreasonable rates for the drugs? I would gladly pay 5 times the cost of making my daughters insulin to support research. Maybe in 10 times. But when we do this, we still have to pay $7000 for a pump - that lasts 4 years - my daughter has had several and they never last over 4 years. The continuous monitor that supports the pump is (I believe $1500) every 3 months. Then you need infusion sets, strips to test, a meter that connects to the pump and monitor, and then of course the insulin. She is now in a masters of occupational therapy and hopefully if she graduates on time she will be done in two years at 22 with some time to spare to get a job with good enough insurance to have her own insurance before they kick her off mine at 26. It is very frustrating. In most areas of life people have to set prices base on competition and supply and demand. This really has nothing to do with the medical professionals anymore, it is the administrators and insurance underwriters. It is a huge racket that rivals the mafioso only this is fully legal if not ethical.
"History doesn't always repeat itself but it often rhymes." - Mark Twain


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