The Glade 4.0

I could be wrong, I would rather I was wrong, but you appear to have gone off the deep end and can no longer be in the same county with this topic without spouting what your masters feed you and tell you is your own thought.

Facism is not a school of thought, it is a racial slur.

Well, you could go with the obvious ones like life expectancy, cancer rates,or heart disease rates.

Of course, these statistics don't prove that they're getting better health care. Like I said, they could have better health for any number of other reasons. However, they do show that people in other first world countries have better health. If we can do whatever it is they do to have better health, our health care costs will also go down, since all else being equal, if people are healthier, health care costs less.

Khross posted the assertion that government is the reason our health care costs are so high AND that you can't make health care better through more government. Virtually every other first-world country has government-run health care. So, I have to ask, is the effect of government relatively equally detrimental to the quality/cost of health care in each country? If it is, then government is not the problem as everyone's in the same boat and we could bring our costs down to match theirs despite things like Obamacare. If it isn't, then we could improve our health care system by changing it to be more like that of a country that's less detrimentally affected, effectively getting better health care through "more government."

Well, you could go with the obvious ones like life expectancy, cancer rates,or heart disease rates.

Of course, these statistics don't prove that they're getting better health care. Like I said, they could have better health for any number of other reasons. However, they do show that people in other first world countries have better health. If we can do whatever it is they do to have better health, our health care costs will also go down, since all else being equal, if people are healthier, health care costs less.

Cancer rates?
How about cancer SURVIVAL rates, that would seem to be a better benchmark of healthcare, no?
http://b-i.forbesimg.com/theapothecary/ ... table1.jpg
Look who's higher than the US...

I will have to disagree Professor. Some of what he is posting are cherry picked facts. Some of what he is posting has become opinion by his presentation.

Then again, I trust neither side and think both are trying to milk the American public for every cent they can with regard to the grater good.

Finally, to this point:



The answer is, in no particular order (because different analysts would probably rank them differently):

a)Technology
b) Regulation (including what some might call "over-regulation", but I'm speaking broadly to the regulation itself)
c) Moral hazard
d) Population diversity
e) Defensive medicine

To put it more succinctly: Bullshit. Technology is not a reason why health care costs are so high.

Let me ask this: does not each new technological device enable access to a previously-untapped revenue stream?

Well, two things are going on here.

1) A simple headache is not grounds for a brain scan, and a general practitioner isn't going to do it. A hospital will, but there are other factors at work there. Namely, a hospital should be assuming you've already seen a general practitioner (even though these days, most people don't do that first).

2) The diagnosis equipment allows doctors to accurately determine maladies. This reduces costs substantially by not wasting resources treating things that aren't wrong with patients. This is what is being overlooked in your analysis.

Hmm, an interesting perspective. I'm not sure it represents a cost savings though, because in the end you're still treating something.

Where such a cost would really be present is in your overall revenue, rather than in your expenses. It's likely that providers would not be spending more money, and in fact they might be spending less. They would not cycle patients out as fast, which would mean less cost, but fewer patients also means less revenue. Likewise, you wouldn't notice the cost on individual patients. With less accurate diagnosis techniques, you won't see people coming back for a second trip because they weren't fixed on the first. Instead, they're dying. That means you can't have a repeat customer.

So the point is that, for example, if you have a complaint and go to the physician, you're getting tests done. Tests that did not exist years ago, thus adding cost.

For example, "cycling" patients out quicker is actually a pretty big goal because it increases revenue, not decreases. Throughput is key to a hospital's top line.

Your counterpoint, if I understand it correctly, is that the tests are improving the efficiency of care to a sufficient degree that their increased cost is offset. Correct?

I think, perhaps, you're misinterpreting what I mean by technology as a factor. And I'm having trouble being clear about it.

In comic strips the person on the left always speaks first. - George Carlin

The answer is, in no particular order (because different analysts would probably rank them differently):

a)Technology
b) Regulation (including what some might call "over-regulation", but I'm speaking broadly to the regulation itself)
c) Moral hazard
d) Population diversity
e) Defensive medicine

Solutions to doctor shortage needed
Experts turn to lawmakers for help
May 21, 2013


As an estimated 14 million additional Americans become eligible for health insurance next year under the Affordable Care Act, recent survey data reveals that the number of doctors entering the healthcare field remains flat, and existing physicians are reducing the number of patients they are willing to service. Solutions to the shortage are urgently needed experts say.

“We are at a critical juncture,” said Steven Wartman, MD, PhD, president and CEO of the Association of Academic Health Centers. “As the 2014 deadline for most Americans to have health insurance approaches, the healthcare workforce is not ready, and we are quickly running out of time.”

Wartman testified before Congress in April urging lawmakers to appropriate funds for the National Healthcare Workforce Commission (NHCWC), so that that agency can work to explore solutions for a looming doctor shortage. According to Wartman, the commission was created by Congress in 2010 but did not receive funding. As a result, the commission has yet to meet.

A growing concern by many experts is that without the active work of the commission, there is no one to lead the charge to explore possible solutions to the shortage problem.

“There will be a shortage of primary care physicians, some surgical specialists, and some pediatric specialists in this country,” Wartman said. “How can we gen-up the workforce to meet the demands – that is the real challenge.”

“The nation needs an integrated, forward-thinking policy,” he added. “And it needs a healthcare workforce that scales up with the population.”

That hasn’t happened for many years, according to Karl Altenburger, MD, a board member of the Physicians Foundation, a nonprofit group that advocates for physicians.

“From 1980 to 2005, the population of the United States grew by 70 million people, an increase of 31 percent,” Altenburger told Healthcare Finance News. “During that same time, no increase in the number of doctors has been produced.”

The Physicians Foundation has been watching this topic for some time, Altenburger said, worried that a shortage of doctors might be coming. The concern is not just with the number of new physicians entering the field, but with attitudes of those already in it Altenburger said.

In 2008, 2010 and 2012, the Physicians Foundation undertook a comprehensive survey of attitudes of physicians in this country about their practice, the healthcare field overall, and changing regulations governing it. The results were not pretty, Altenburger said.

Data from those surveys reveals a physician population that is increasing frustrated, stressed, over-worked and dissatisfied with having chosen the medical profession for a career.

“Sixty percent of physicians say they would retire if they could,” Altenburger stressed.

While many aren’t taking that extreme route, they are reducing the perceived pain.

“Many of the physicians we’ve talked to want to cut back on the number of patients they see,” Altenburger said. The result will be more patients requiring physician services, but having a longer wait to receive them.

Beyond the shortage of doctors, Altenburger also worries about a misalignment of healthcare workers to healthcare needs. This is partially driven by an aging U.S. population. But it will also be impacted by millions of newly insured Americans that have previously priced out of preventive care.

Altenburger said there are other healthcare professionals able to step up and help fill the void temporarily.

“In the interim, there are a number of groups that assist physicians that can do minor diagnostic and treatment care,” Altenburger said. “Under the supervision of a physician, these teams can go very well.”

Altenburger said his hope is that a realignment of healthcare providers to required services will help the nation weather the immediate physician shortage. That will buy the country some time. But the real burden will fall on Congress to act on long-term solutions, he said.

[...]
Anyway, the point of all that is that although the bill was obviously going to be astronomical, at no point in the entire process did I, my brother or my parents ever ask about or care about price, and we wouldn't have asked or cared even if we didn't have insurance. There was a very realistic concern, based on the presentation of symptoms and the results of the initial tests, that my 21 year old brother was at risk of sudden death, and my entire family would have unhesitatingly bankrupted itself and/or spent the rest of our lives under a crushing debt load to be sure he got the best possible care to prevent that from happening. When you have that kind of "price doesn't matter" mentality driving demand for something, the price is inevitably going to be very, very high.

Personally, I'd file that under moral hazard. You're insulated from the cost, so you spend more without thinking of it. This can be because of the 3rd party payments inherent in the current system, or the lack of regard for cost in a time of emergency. Either way, you're removed from the purchase sufficiently enough that I think it generates a moral hazard in the economic sense.

I think moral hazard only refers to the 3rd party payment issue, but I do agree that it's a factor in the price inelasticity, particularly when it comes to treatment of non-emergency, minor to moderate severity conditions. My point, though, is that even if you eliminate the 3rd party payments, demand for health care is inherently price inelastic given the nature of the service being purchased. It's not perfectly inelastic, but the more serious or urgent the condition being treated, the closer to perfect inelasticity the demand becomes. A potentially life-threatening emergency like my brother experienced generates near-perfect inelasticity, but I suspect that even less serious/urgent conditions generate demand curves that are more price inelastic than the demand for most other goods and services out there.

Facism is not a school of thought, it is a racial slur.

Let me be perfectly clear here, there was only one way in the United States for unexpected healthcare expenses to bankrupt you: until Obamacare total ignorance of your legal ability to seek indigent care relief REGARDLESS of income and wealth.

This is ridiculous. There are conditions that you can get that WILL kill you if you don't receive a patented, brand name treatment costing $100,000+ per year. If you don't fork out, you don't survive. EMTALA does not force hospitals to provide these drugs either if you can't afford them. No alternative or generic treatments exist because the drugs are newly developed and still under patent. The most prominent examples are CML and multiple myeloma. Ten years ago these were death sentences, you did not survive long. Today you can live almost a normal lifespan - if you have $100,000/year to spend on the new drugs. This was not different before Obamacare.

Facism is not a school of thought, it is a racial slur.

the FDA killed 400 Germans funding research to develop generic Epogen.