Health care costs set to increase sharply next year... thanks, Obamacare!

[ludin]

that's because they used 90%... which is close to what we have insured.

That 10% without insurance that doesn't get preventative medician costs a lot.

No.. I didn't miss the big picture. I understand the big picture which is when a clinician decides that a person is at risk and makes a good clinical decision to test and prevent disease and illness it saves money.

the studies focused on getting CT's.. etc...

When the largest issue in preventative medicine is seeing a physician or other qualified healthcare provider. which people that don't have insurance don't have easy access to unless its already an emergency.



The key is and always has been in identifying people appropriately who need care. THATS the preventative medicine.. and people that don't see the physician because they have no insurance don't see a physician until its very costly.

you can ignore the article it doesn't matter the fact is that preventive care does not lower costs it in fact increases them.

 

[Threegoofs]

Well, since there are very few that are a good value.. It's not as absurd as you might believe.

There are tons that are good value.

https://www.prevent.org/National-Co...reventive-Services-for-the-US-Population.aspx

There are many more that are not, but you don't judge the effectiveness of medical treatment by listing all the treatments that DONT work, do you?

 

[jaeger19]

no, they achieve the same or better outcomes for most diseases at a fraction of the cost. the American system is so expensive that people stay away from the doctor until treatment is unavoidable, and that adds to the cost, as well. meanwhile, we deliver universal healthcare for the uninsured at the emergency room, which is the most inefficient system imaginable, and which you and i pay for in the cost of our premiums.

i suppose that you're going to have to be reminded of this every time a healthcare thread is posted. if you'd like to continue, i'll start posting the charts and data again.

Actually yes.. I am right.

1. As pointed out.. that fraction of the cost is influence by the fact that they pay for education for their physicians. they pay for safety nets that let people retire earlier particularly in hard physical labor jobs, they pay for malpractice systems etc. Which is money that doesn't get factored in the "cost of healthcare".. as it does in the US. But its still a cost just has been shifted to another category.

2. The don't achieve better outcomes or the same in general. When it comes to effectiveness and treatment.. we rank in the top ten and in many specialties.. etc.. we rank in the top 5 of developed countries. Its in our "efficiency" and "equity"..ratings where it appears we don;t have good outcomes. But outcomes for conditions when you have insurance? We are one of the best in the world. You are far more likely to survive cancer here in the US than Britain..and most of Europe as well.

3. Other countries that have universal government coverage have wide swings in cost as well.. even with comparable life spans. as already pointed out.. Britain and South Korea have relatively the same lifespans yet Britain spends I think at least twice and maybe three times for that healthcare. SO the differences in costs don't correlate to whether they have universal government coverage or not. So obviously other factors are much bigger players than Universal healthcare coverage things like comorbidities, culture demographics, etc.
You have made the erroneous assumption that the variation in what we spend versus other countries is due to our healthcare system... when your very own charts show that place with the same healthcare systems.. still have large variations in spending.

4. There is a point about the uninsured in this country costing heavily because of being seen in the emergency room. I certainly recognize that as a provider. However roughly 90% of americans are insured. Lowering their quality of health insurance.. to provide only 10% with marginal coverage seems not so smart. Much better to raise the 10% without health coverage to getting good or better coverage that the 90% make.

5. You fail to recognize that we have government programs that cover people.. the VA and Medicaid.. and both of those programs are about the worst for coverage. Both of those programs are about the coverage that the public gets in Canada, and the UK.
Medicare is a much better animal. Its so good that our wealthy like it where in other countries the wealthy ditch their public system. However, medicare only works financially because you pay your whole working life and only get coverage at the end of life.

I suppose you are going to have to be reminded of these facts everytime a healthcare thread is posted. If you would like to continue.. please again post the charts and data again.. and yet again I will point out what mistakes you are making in interpreting the meaning of the charts and data.

 

[buck]

There are tons that are good value.

It's relatively few. Meaning there are far more that are not a good value and many of those are now included free due to Obamacare.

 

[jaeger19]

you can ignore the article it doesn't matter the fact is that preventive care does not lower costs it in fact increases them.

I don't ignore the article.. not at all. It confirms what every provider knows. That it depends on what you call "preventative care". Giving everyone a CT for lung cancer is not cost effective.

YEP. Even you article said that. We know it.

BUT.. a high risk smoker, with a new chronic unresolved cough, unexplained loss of weight.. and a family history of lung cancer? Probably better to have at least an x ray. AND THATS preventative medicine. Because catching his cancer, or heck.. his burgeoning pneumonia is cheaper. (unless you are willing to let him die.. then overall its less expensive)

the article is stating "preventative medicine".. as people seeing a physician and "getting CT's" .

Not realizing that seeing a physician is preventative medicine.

 

[jaeger19]

again the article is pretty clear if 90% of americans did preventive care it would only lower the cost of medical expense by .2%.
which is basically nothing.

That's because 90% of americans are not sick.

Its getting those that are sick appropriate care early.. and that's preventative medicine.

 

[sangha]

Would you care to provide us some examples, of these many instances, to support that (bolded above) "fact"?

In many cases that preventive care is simply a test or a vaccination taking very little time (if any) from a doctor. Except for an annual check-up, and twice a year prescription renewal approval, all of my preventive care is supplied by a nurse at an annual cost (including prescription medication) of about $250.

There are examples, such as MRI's. However, there's a simple solution for those examples - don't cover preventative care that doesn't have a sufficient financial payback

 

[buck]

I don't ignore the article.. not at all. It confirms what every provider knows. That it depends on what you call "preventative care". Giving everyone a CT for lung cancer is not cost effective.

YEP. Even you article said that. We know it.

BUT.. a high risk smoker, with a new chronic unresolved cough, unexplained loss of weight.. and a family history of lung cancer? Probably better to have at least an x ray. AND THATS preventative medicine. Because catching his cancer, or heck.. his burgeoning pneumonia is cheaper. (unless you are willing to let him die.. then overall its less expensive)

the article is stating "preventative medicine".. as people seeing a physician and "getting CT's" .

Not realizing that seeing a physician is preventative medicine.

Not just CT Scans... Even simple physicals and cholesterol/blood sugar checks are not cost effective. That is the type of preventive care that some of the studies looked at.

One big reason why preventive care does not save money, say health economists, is that some of the best-known forms don't actually improve someone's health.

These low- or no-benefit measures include annual physicals for healthy adults. A 2012 analysis of 14 large studies found they do not lower the risk of serious illness or premature death. But about one-third of U.S. adults get them, said Dr. Ateev Mehrota, a primary-care physician and healthcare analyst at RAND, for a cost of about $8 billion a year.

 

[sangha]

That doesn't make you an expert on the costs of preventative care. There is a field that directly studies that. In fact, a couple from that field were quoted in the articles I posted.

Now, if I wanted to order some pills or know what pills would work best, I would certainly want to talk to you.

But, the studies and the health care economists indicate that in most cases, preventative care is more expensive. There are some exceptions.

Your quotes do not support your claim that "in most cases, preventative care is more expensive". What they say is that in SOME cases, it's more expensive and in SOME cases, it saves money

Obviously, we need to more of the latter, and less of the former

 

[buck]

Your quotes do not support your claim that "in most cases, preventative care is more expensive". What they say is that in SOME cases, it's more expensive and in SOME cases, it saves money

Actually, the exceptions are those that save money, which is indicated in the article. Most are not.

 

[sangha]

Actually, the exceptions are those that save money, which is indicated in the article. Most are not.

Neither the quotes you posted, nor the article, support your claim

 

[buck]

Neither the quotes you posted, nor the article, support your claim

Nope, not supported at all:

Some disease-prevention programs do produce net savings. Childhood immunizations, and probably some adult immunizations (such as for pneumonia and the flu), are cost-saving, found a 2009 analysis for the Robert Wood Johnson Foundation. The vaccines are cheap, and large swaths of the population are vulnerable to the diseases they prevent. The cost of providing them to everyone is less than that of treating the illnesses they prevent.

Counseling adults about using baby aspirin to prevent cardiovascular disease also produces net savings. The counseling is inexpensive, the aspirin even cheaper and the costs of heart disease, which strikes one in three U.S. adults, are enormous. Screening pregnant women for HIV produces net savings, too.

Those, however, are exceptions.

HIGH COSTS, NO BENEFITS

One big reason why preventive care does not save money, say health economists, is that some of the best-known forms don't actually improve someone's health.

 

[sangha]

Nope, not supported at all:

That quote supports what I said, not what you said

I said some cost more and some cost less, which you just confirmed. Nowhere does it say what you said - that almost all cost more.

 

[jaeger19]

Not just CT Scans... Even simple physicals and cholesterol/blood sugar checks are not cost effective. That is the type of preventive care that some of the studies looked at.

Yep... you aren't telling me anything I don't know.

What I am telling you what you don't know or don't seem to know that preventative medicine is seeing an fellow who is not healthy EARLY.. and then giving him appropriate tests RATHER than wait.

for example.. its preventative medicine to have the fellow that's had several episodes of his chest tightening.. to come in and see the doctor.... and have a work up and end up on some preventative medication. and far far cheaper.

then have him collapse at work and have serious emergency that now requires surgery.

Gee... does it really take a rocket science to understand that there is low or no benefit to get annual physicals for healthy adults ? I mean what part of HEALTHY ADULT do you not understand? That's why the statement that preventative medicine doesn't work is really a silly statement when you include checkups on HEALTHY ADULTS. Cripes.. if they are healthy.. what are you treating?.
But getting physicals for people with progressive problems.. or high risk patients with issues... these aren't healthy adults... these are check ups on UNHEALTHY adults.. and that is what preventative medicine is about.

That's the problem with a lot of this stuff... people love headlines.. and don't understand what the research actual says and what valid conclusions can really be drawn from it.

 

[Helix]

Actually yes.. I am right.

no, you're not. you have been as consistently wrong on this topic as anyone that i've seen.

1. As pointed out.. that fraction of the cost is influence by the fact that they pay for education for their physicians. they pay for safety nets that let people retire earlier particularly in hard physical labor jobs, they pay for malpractice systems etc. Which is money that doesn't get factored in the "cost of healthcare".. as it does in the US. But its still a cost just has been shifted to another category.

2. The don't achieve better outcomes or the same in general. When it comes to effectiveness and treatment.. we rank in the top ten and in many specialties.. etc.. we rank in the top 5 of developed countries. Its in our "efficiency" and "equity"..ratings where it appears we don;t have good outcomes. But outcomes for conditions when you have insurance? We are one of the best in the world. You are far more likely to survive cancer here in the US than Britain..and most of Europe as well.

we've already been over this a million times. i think that we should just make this one quick. so,

3. Other countries that have universal government coverage have wide swings in cost as well.. even with comparable life spans. as already pointed out.. Britain and South Korea have relatively the same lifespans yet Britain spends I think at least twice and maybe three times for that healthcare. SO the differences in costs don't correlate to whether they have universal government coverage or not. So obviously other factors are much bigger players than Universal healthcare coverage things like comorbidities, culture demographics, etc.
You have made the erroneous assumption that the variation in what we spend versus other countries is due to our healthcare system... when your very own charts show that place with the same healthcare systems.. still have large variations in spending.

4. There is a point about the uninsured in this country costing heavily because of being seen in the emergency room. I certainly recognize that as a provider. However roughly 90% of americans are insured. Lowering their quality of health insurance.. to provide only 10% with marginal coverage seems not so smart. Much better to raise the 10% without health coverage to getting good or better coverage that the 90% make.

5. You fail to recognize that we have government programs that cover people.. the VA and Medicaid.. and both of those programs are about the worst for coverage. Both of those programs are about the coverage that the public gets in Canada, and the UK.
Medicare is a much better animal. Its so good that our wealthy like it where in other countries the wealthy ditch their public system. However, medicare only works financially because you pay your whole working life and only get coverage at the end of life.

I suppose you are going to have to be reminded of these facts everytime a healthcare thread is posted. If you would like to continue.. please again post the charts and data again.. and yet again I will point out what mistakes you are making in interpreting the meaning of the charts and data.

http://www.commonwealthfund.org/~/m...t_sys_comparison_12_nations_intl_brief_v2.pdf

Forbes Welcome

 

[Threegoofs]

no, you're not. you have been as consistently wrong on this topic as anyone that i've seen.



we've already been over this a million times. i think that we should just make this one quick. so,



http://www.commonwealthfund.org/~/m...t_sys_comparison_12_nations_intl_brief_v2.pdf

Forbes Welcome

All I can tell you guys is that in the large multinational company I'm in, we have had this conversation, and all of the Europeans would rather go back home and get treated for serious illnesses than stay in the US.

These are Germans, English and French nationals.

And they all are physicians who are quite knowledgable about their own healthcare systems as well as the US system. They generally make fun of how infuriatingly confusing it is to the end user.

 

[buck]

That quote supports what I said, not what you said

I said some cost more and some cost less, which you just confirmed. Nowhere does it say what you said - that almost all cost more.

I guess that is true.. As long as you either ignore or do not understand the word "exception".

The ones that save money are the exceptions.. Which means the ones that cost more are the rule.

 

[sangha]

I guess that is true.. As long as you either ignore or do not understand the word "exception".

The ones that save money are the exceptions.. Which means the ones that cost more are the rule.

None of which means "nearly all" which is what you said.

I understand you want to believe it, but in nearly all cases it just isn't true

 

[joG]

That's because 90% of americans are not sick.

Its getting those that are sick appropriate care early.. and that's preventative medicine.

If that's what you want call for better parents to teach their kids right. It's like flossing.

 

[buck]

None of which means "nearly all" which is what you said.

Yes, you may not actually know the definition of exception.

ex·cep·tion
a person or thing that is excluded from a general statement or does not follow a rule.

The general rule in this case is that most preventative care costs more.

Or, in other words, you were wrong:

Quote Originally Posted by buck View Post
Actually, the exceptions are those that save money, which is indicated in the article. Most are not.

Neither the quotes you posted, nor the article, support your claim

 

[buck]

What I am telling you what you don't know or don't seem to know that preventative medicine is seeing an fellow who is not healthy EARLY.. and then giving him appropriate tests RATHER than wait.

If you are saying that someone that already has a disease seeing a doctor for more testing related to that disease is preventative, then no. I did not know that.

 

[sangha]

Yes, you may not actually know the definition of exception.



The general rule in this case is that most preventative care costs more.

Or, in other words, you were wrong:

Here's what you said

I understand you want to believe it, but in nearly all cases it just isn't true

You were wrong.

 

[Helix]

All I can tell you guys is that in the large multinational company I'm in, we have had this conversation, and all of the Europeans would rather go back home and get treated for serious illnesses than stay in the US.

These are Germans, English and French nationals.

And they all are physicians who are quite knowledgable about their own healthcare systems as well as the US system. They generally make fun of how infuriatingly confusing it is to the end user.

and you'll notice that Canadian and European conservatives rarely if ever show up in these threads and talk about how much they'd like to trade systems with us. but maybe one will eventually. that will be a fun discussion.

 

[buck]

Here's what you said


You were wrong.

Most preventative care costs more. It's just a fact. There are only a small amount of exceptions where that is not the case.

 

[jaeger19]

no, you're not. you have been as consistently wrong on this topic as anyone that i've seen.



we've already been over this a million times. i think that we should just make this one quick. so,



http://www.commonwealthfund.org/~/m...t_sys_comparison_12_nations_intl_brief_v2.pdf

Forbes Welcome

Great... read your own charts..

Lets just start with the forbes chart: Lets see where the US scores:

Quality of care: 5
Effective care: 3
Patient centered care 4

But but but.. the headlines say the US RANKS DEADLAST. Ohhhh... oh wait.. effective care 3, quality of care total 5.. patient centered care 4 timeliness of care... 5.

Now that's not deadlast is it?

Oh wait.. lets throw in the OTHER variables: equity 11, efficiency 11.. healthy lives 11.

Gee.. now what was it that Jaeger stated..

The don't achieve better outcomes or the same in general. When it comes to effectiveness and treatment.. we rank in the top ten and in many specialties.. etc.. we rank in the top 5 of developed countries. Its in our "efficiency" and "equity"..ratings where it appears we don;t have good outcomes. But outcomes for conditions when you have insurance? We are one of the best in the world. You are far more likely to survive cancer here in the US than Britain..and most of Europe as well

Okay.. you tell me exactly where what I said is "Consistently wrong"...

just because you looked at the headlines and don't understand the whole data is not MY fault. Just because you have a preconceived conclusion and don't understand the whole issue is not my fault. I have tried to educate you.